Cigarette smoking accounts for about one-fifth of all deaths from heart disease in the United States. Smokers have a two- to fourfold increase in coronary artery disease and about a 70 percent higher death rate from coronary artery disease than do nonsmokers. Smoking is a major risk factor for heart disease.

Smoking And Your Health

Most people associate cigarette smoking with breathing problems and lung cancer. But smoking is also a major cause of cardiovascular (heart and blood vessel) disease.

Smoking: the No. 1 cause of preventable disease and death

Smoking and tobacco use are significant risk factors for a variety of chronic disorders. According to the American Heart Association, cigarette smoking is the most important preventable cause of premature death in the United States, accounting for 440,000 of the more than 2.4 million annual deaths.

Smoking is a major cause of atherosclerosis — a buildup of fatty substances in the arteries. Atherosclerosis occurs when the normal lining of the arteries deteriorates, the walls of the arteries thicken and deposits of fat and plaque block the flow of blood through the arteries. In coronary artery disease, the arteries that supply blood to the heart become severely narrowed, decreasing the supply of oxygen-rich blood to the heart, especially during times of increased activity. Extra strain on the heart may result in chest pain (angina pectoris) and other symptoms. When one or more of the coronary arteries are completely blocked, a heart attack (injury to the heart muscle) may occur.

In peripheral artery disease, atherosclerosis affects the arteries that carry blood to the arms and legs. As a result, the patient may experience painful cramping of the leg muscles when walking (a condition called intermittent claudication). Peripheral artery disease also increases the risk of stroke.

A person’s risk of heart attack greatly increases with the number of cigarettes he or she smokes. There is no safe amount of smoking. Smokers continue to increase their risk of heart attack the longer they smoke. People who smoke a pack of cigarettes a day have more than twice the risk of heart attack than nonsmokers.

Women who smoke and also use oral contraceptives (birth control pills) increase several times their risk of coronary and peripheral artery diseases, heart attack and stroke, compared with nonsmoking women who use oral contraceptives.

What other medical conditions are linked with smoking?

Cigarettes have multiple poisons, including addictive nicotine, carbon monoxide, “tars” and hydrogen cyanide. There are 4,000 other chemicals of varying toxicity, including 43 known carcinogens.

Smoking causes:

  • Decreased oxygen to the heart and to other tissues in the body
  • Decreased exercise tolerance
  • Decreased HDL (good) cholesterol
  • Increased blood pressure and heart rate
  • Damage to cells that line coronary arteries and other blood vessels
  • Increased risk of developing coronary artery disease and heart attack
  • Increased risk of developing peripheral artery disease and stroke
  • Increased risk of developing lung cancer, throat cancer, chronic asthma, chronic bronchitis and emphysema
  • Increased risk of developing diabetes
  • Increased risk of developing a variety of other conditions including gum disease and ulcers
  • Increase tendency for blood clotting
  • Increased risk of recurrent coronary artery disease after bypass surgery
  • Increased risk of becoming sick (especially among children: respiratory infections are more common among children exposed to second-hand smoke)

How does cigarette smoke affect others?

Cigarette smoke does not just affect smokers. When you smoke, the people around you are also at risk for developing health problems, especially children. Environmental tobacco smoke (also called passive smoke or second-hand smoke) affects people who are frequently around smokers. Second-hand smoke can cause chronic respiratory conditions, cancer and heart disease.

The American Heart Association estimates that each year, about 37,000 to 40,000 people die from heart and blood vessel disease caused by other people’s smoke.

The benefits of quitting smoking

Now that you know how smoking can be harmful to your health and the health of those around you, here’s how quitting smoking can be helpful. If you quit smoking, you will:

  • Prolong your life. According to the American Heart Association, smokers who quit between ages 35-39 add an average of 6-9 years to their lives. Smokers who quit between ages 65-69 increase their life expectancy by 1 – 4 years.
  • Reduce your risk of cardiovascular disease. Quitting smoking reduces the risk of repeat heart attacks and death from heart disease by 50 percent or more. Quitting smoking also reduces your risk of high blood pressure, peripheral artery disease and stroke.
  • Reduce your risk of developing a variety of other conditions including diabetes, lung cancer, throat cancer, emphysema, chronic bronchitis, chronic asthma, ulcers, gum disease and many other conditions.
  • Feel healthier. After quitting, you won't cough as much, have as many sore throats and you will increase your energy.
  • Look and feel better. Quitting can help you prevent face wrinkles, get rid of stained teeth, improve your skin and even get rid of the stale smell in your clothes and hair.
  • Improve your sense of taste and smell.
  • Save money.

How can I quit?

There's no one way to quit that works for everyone. To quit smoking, you must be ready emotionally and mentally. You must also want to quit smoking for yourself, and not to please your friends or family. Plan ahead.

Before you quit: a checklist

Check off the items on this list as you accomplish them:

  • _____ Pick a date to stop smoking and then stick to it.
  • _____ Write down your reasons for quitting. Read over the list every day, before and after you quit.
  • _____ Write down when you smoke, why you smoke and what you are doing when you smoke to learn your smoking "triggers."
  • _____ Stop smoking in certain situations (such as at your work break or after dinner) before actually quitting.
  • _____ Make a list of activities you can do instead of smoking.
  • _____ Visualize yourself as a nonsmoker.
  • _____ Tell your family and friends about your plans to quit and ask them for their support. Ask your family members who smoke to quit with you.
  • _____ Ask your health care provider about using smoking cessation aids to help you quit smoking. Nicotine replacement aids include gum, nicotine patches, inhalers, sublingual (under-the-tongue) tablets, lozenges, nasal spray or prescription medications.
  • _____ Join a smoking cessation support group or program. See the Resources at the end of this information.

When you quit

  • Get rid of all cigarettes.
  • Put away all smoking-related objects, such as ashtrays.
  • If you live with a smoker, ask that person not to smoke in your presence. Better yet, convince them to quit with you.
  • Don’t focus on your cravings. Remember that what you’re feeling is temporary and remind yourself why you want to quit.
  • Keep yourself busy! Review your list of activities you can do instead of smoking.
  • When you get the urge to smoke, take a deep breath. Hold it for ten seconds and release it slowly. Repeat this several times until the urge to smoke is gone.
  • Keep your hands busy. Doodle, play with a pencil or straw, or work on a computer.
  • Change activities that were connected to smoking. Take a walk or read a book instead of taking a cigarette break.
  • When you can, avoid places, people and situations associated with smoking. Hang out with non-smokers or go to places that don't allow smoking, such as the movies, museums, shops or libraries.
  • Don't substitute food or sugar-based products for cigarettes. Eat low-calorie, healthful foods (such as carrot or celery sticks, sugar-free hard candies) or chew gum when the urge to smoke strikes so you can avoid weight gain.
  • Drink plenty of fluids, but limit alcoholic and caffeinated beverages. They can trigger urges to smoke.
  • Remind yourself you are a nonsmoker. Nonsmokers don't smoke.
  • Exercise. Exercising has many benefits and will help you relax.

How will I feel when I quit?

  • You may crave cigarettes, be irritable, feel very hungry, cough often, get headaches, have difficulty concentrating or experience constipation. These symptoms of withdrawal occur because your body is used to nicotine, the active addicting agent within cigarettes.
  • When withdrawal symptoms occur within the first two weeks after quitting, stay in control. Think about your reasons for quitting. Remind yourself that these are signs that your body is healing and getting used to being without cigarettes.
  • The withdrawal symptoms are only temporary. They are strongest when you first quit but will go away within 10 to 14 days. Remember that withdrawal symptoms are easier to treat than the major diseases that smoking can cause.
  • You may still have the desire to smoke. There are many strong associations with smoking, such as smoking during specific situations, with a variety of emotions or with certain people in their lives. The best way to overcome these associations is to experience them without smoking.

What happens when you quit

  • After 20 minutes
    • You stop polluting the air
    • Your blood pressure and pulse decrease
    • The temperature of your hands and feet increases
  • After 8 hours
    • The carbon monoxide level in your blood returns to normal
    • Oxygen levels in your blood increase
  • After 24 hours
    • Your risk of heart attack decreases
  • After 48 hours
    • Nerve endings adjust to the absence of nicotine
    • Your ability to taste and smell begin to return
  • After 2 weeks to 3 months
    • Your circulation improves
    • Your exercise tolerance improves
  • After 1 – 9 months
    • Coughing, sinus congestion, fatigue and shortness of breath decrease
    • Your overall energy level increases
  • After 1 year
    • Your risk of heart disease decreases to half that of a current smoker
  • After 5 – 15 years
    • Your risk of stroke is reduced to that of people who have never smoked
  • After 10 years
    • Your risk of dying from lung cancer drops to almost the same rate as a lifelong non- smoker
    • You decrease the incidence of other cancers — of the mouth, larynx, esophagus, bladder, kidney and pancreas
  • After 15 years
    • Your risk of heart disease is reduced to that of people who have never smoked

If you smoke again (called a relapse) do not lose hope. Seventy-five percent of those who quit relapse. Most smokers quit three times before they are successful. If you relapse, don’t give up! Review the reasons why you wanted to become a nonsmoker. Plan ahead and think about what you will do next time you get the urge to smoke.

Resources: where to get help

You may also contact your local chapter of the American Cancer Society, American Heart Association, or the American Lung Association. There are numerous government resources online to help you quit smoking, including the Centers for Disease Control, National Cancer Institute, National Clearinghouse for Alcohol and Drug Information, World Health Organization Tobacco Free Initiative, and many more. See:

No Smoking Policy

Because we care about your health, smoking is not permitted anywhere on the Cleveland Clinic campus. We strongly encourage you to stop smoking. Please see the Resources in the section above to get help.

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Reviewed: 12/13

Reviewed by a Cleveland Clinic medical professional.

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