Most people associate cigarette smoking and tobacco use 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, tobacco use is the leading cause of preventable death in the United States, accounting for over 400,000 deaths each year.

About 8.6 million people in the US have at least one serious illness caused by smoking.

Smokers die significantly earlier than nonsmokers: 13.2 years for men and 14.5 years for women.

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. Coronary artery disease can lead to a heart attack.

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.

Cigarette smoking increases the risk of serious cardiovascular side effects from oral contraceptive use (birth control pills). The risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age. In addition to the increased risk of heart attack, there is also an increased risk of blood clots, pulmonary embolism, peripheral artery disease, stroke and deep vein thrombosis.

What other medical conditions are linked with smoking?

Cigarettes have multiple poisons, including addictive nicotine, carbon monoxide, "tars," and hydrogen cyanide. There are 7000 other chemicals of varying toxicity, including 69 known to cause cancer. (U.S Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General, 2010.)


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
  • 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
  • Increased tendency for blood clotting
  • Increased risk of recurrent coronary artery disease after bypass surgery
  • Damage to cells that line coronary arteries and other blood vessels
  • Increased risk of impotence
  • Increased risk of fertility problems
  • Increased wrinkles
  • Increased risk of becoming sick (especially among children: respiratory infections are more common among children exposed to secondhand smoke)

How does smoking affect others?

Cigarette smoke doesn't just affect smokers. When you smoke, the people around you are at risk for developing health problems, especially children. Secondhand smoke (also called passive smoke or environmental tobacco smoke) affects people who are frequently around smokers. Secondhand smoke can cause chronic respiratory conditions, cancer, and heart disease. The American Heart Association estimates that each year, about 46,000 people die from heart and blood vessel disease caused by secondhand smoke.

Secondhand smoke contains more than 250 chemicals known to be toxic or cancer-causing.

Children who are exposed to secondhand smoke are inhaling many of the same cancer-causing substances and poisons as smokers.

The benefits of quitting smoking

Now that you know how smoking can be harmful to your health and the health of those around you, find out how quitting smoking can be helpful.

By quitting smoking, you will:

  • Prolong your life: According to the American Heart Association, smokers who quit between the ages of 35 and 39 add an average of 6 to 9 years to their lives. Smokers who quit between the ages of 65 and 69 increase their life expectancy by 1 to 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.
  • Reduce your risk of high blood pressure, peripheral artery disease, and stroke.
  • Reduce your risk for 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 or have as many sore throats, and you will increase your stamina.
  • Look and feel better. Quitting can help you prevent 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: a pack a day habit in Ohio costs over $2,000 per year.

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. Quitting has two components: managing the nicotine addiction withdrawal and changing your behavior or habits. Plan ahead.

Before you quit:

(Check off these items as you accomplish them)

  • Make a personal pact with yourself to quit and realize the reasons why you want to quit!
  • Write down, on a card, the three most important reasons for quitting.
  • Carry that card with you (or in your cigarette box) from now on. Look at it several times each day.
  • Set a date for quitting completely! (My QUIT date is //___).
  • Make sure to let your friends and family know that you are quitting smoking, especially if they smoke.
  • Consider reducing your smoking with the taper method a few weeks before your quit date. If you are over a pack, try to get less than a pack.
  • Identify barriers or triggers that may cause you to smoke.
  • Prior to quitting, taper or eliminate smoking completely in two or three of your high risk situations, for example, stop smoking in the car or skip a smoke break at work.
  • Understand that withdrawal symptoms may come, what they are, and be prepared for their occurrence.
  • Spend a little time each day picturing in your mind stressful events occurring in the future and you not smoking.
  • Get rid of ALL cigarettes and smoking related objects such ashtrays and lighters. Ask people you live with not to smoke in your presence for at least two weeks.
  • Consider the following for extra support: A person to quit with you; Joining a web-based program; Reading a book on quitting; Calling the Quit line (1-800-QUITNOW)
  • Change to a less desirable brand of cigarettes.
  • Discard your lighter, use matches.
  • Carry your cigarettes in a different place.

When you quit:

  • Again get rid of ALL cigarettes!
  • Get rid of all smoking related objects such ashtrays. Ask people you live with not to smoke in your presence for two weeks
  • Be prepared for the hump days after the quit day (Days 2-5)! When cravings come - remind yourself of why you are quitting (from your card) and that cravings will last only a few seconds to minutes!
  • When urges and withdrawal symptoms come - remind yourself that whatever discomfort you are experiencing is only a tiny fraction of the probable discomfort associated with continued smoking (i.e., painful diseases, surgery, chemotherapy).
  • Spend as much time as possible with non-smoking people.
  • Keep busy, especially on evenings and weekends.
  • Avoid "high risk" situations (large parties, bars, etc.), and spend lots of time in places which prohibit or discourage smoking (e.g., theaters, libraries).
  • Use approved alternates (e.g., ice water, high bulk/low calorie foods, sugarless gum, mouthwash, & brushing teeth). Don't substitute food or sugar based products for cigarettes.
  • Drink plenty of fluids (avoid excess caffeine in pop, coffee, or tea)
  • Begin (or increase) a regular exercise program. Try to work up to 10,000 steps a day.
  • Practice deep breathing or other relaxation techniques. Take a deep breath in through the nose and slowly blow out through the mouth.
  • Take your medication(s) as designated by your clinician.
  • Remind yourself that you can free yourself from this unhealthy, expensive, messy habit and become a nonsmoker.

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.

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.

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 start re-growing
Your ability to taste and smell is enhanced

After 2 weeks to 3 months
Your circulation improves
Your exercise tolerance improves

After 1 to 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 to 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 risk 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

How does it work?

  1. You'll start by meeting with a tobacco cessation specialist. You'll learn how much you depend on nicotine, how ready you are to quit, and what your preferred method of learning is.
  2. Your specialist will develop a personalized treatment plan for you. This may include tobacco treatment medication such as varenicline (Chantix®), bupropion (Zyban®) and nicotine replacement therapy (NRT) such as nicotine gum, lozenge or patch. Behavioral therapy such as appropriate reading material, web-based programs, and individual or group counseling will also be available.
  3. The tobacco treatment specialist will stay in touch with you to check on your progress, find out how well treatment is working for you - and celebrate your successes.

Program cost

Treatment costs vary based on the personalized treatment plan developed for each participant.

For more information or to schedule an appointment, call 216.444.8111. Appointments can be made at Main campus, Lyndhurst campus, Avon, Independence, Strongsville, Twinsburg, and Willoughby Hills Family Health Centers.

Ohio Quitline: 1.800.QUIT-NOW (1.800.784-8669)

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.

Smoking causes both immediate and long-standing effects on exercise and physical activity. In addition to increasing the well-known risks for cancer and heart and respiratory diseases, smokers have less endurance, poorer physical performance, and increased rates of injury and complications from physical activity.

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