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How is Smoking Linked to Heart Disease and Other Heart Issues?

Curated by Claudia Shannon / Research Scientist / ishonest

Smoking tobacco affects almost every organ in the body. It can cause many health risks and complications, including those that affect the heart.

In fact, smoking affects the entire cardiovascular system, which includes the heart, blood, and blood vessels.

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The cardiovascular side effects of smoking can be serious. Over time, they can cause severe health issues like stroke or heart failure.

To learn more about how smoking affects the heart, read on.

How smoking tobacco affects heart health

Cardiovascular disease (CVD) is an umbrella term for diseases that affect the heart or blood vessels.

Since CVD refers to any disease involving the heart or blood vessels, most heart-related smoking issues fall into this category. But some conditions are causes of CVD, rather than types.

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In terms of heart health, smoking can lead to:

High blood pressure

High blood pressure is when the blood in your arteries flows with too much force. It’s also called hypertension.

Cigarette smoke causes high blood pressure because it contains nicotine. Nicotine is a harmful chemical that increases blood pressure.


In atherosclerosis, the arteries become narrow and stiff due to plaque buildup. Plaque is made of substances like cholesterol, fat, and scar tissue.

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Plaque blocks blood flow, making it difficult for blood to reach other parts of the body, and it also causes inflammation.

Specifically, cigarette smoke causes and worsens atherosclerosis by increasing inflammation. The inflammation promotes cholesterol and plaque buildup, which accumulate in the arteries.

Also, smoking causes hypertension, which increases the risk of atherosclerosis. That’s because high blood pressure places extra strain on the arteries, making them more susceptible to stiffness and cholesterol buildup.


Arrhythmia is an irregular heartbeat. It’s also called an abnormal heart rhythm.

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Smoking triggers cardiac fibrosis, or the scarring of heart muscle. This can lead to an irregular heartbeat or a fast heartbeat, also known as tachycardia.

The nicotine in cigarettes also increases heart rate, which can lead to tachycardia.


Smoking promotes the formation of plaque and clots, which can block blood vessels throughout the body. If this occurs in the brain, it can cause a stroke.

A stroke, or a brain attack, happens when blood flow to the brain is interrupted. This occurs when a blood vessel in the brain is blocked or bursts.

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In turn, the brain is unable to get enough oxygen and brain cells die.

Heart attack

If smoking blocks blood flow to the heart, it can cause a heart attack. This is also called a myocardial infarction.

Without enough oxygen-rich blood, the heart muscle starts to die.

Heart failure

Heart failure occurs when the heart is unable to pump enough blood to the body. Many conditions can lead to heart failure. Smoking-related causes include CHD and arrhythmia.

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Therefore, as smoking contributes to these conditions, it also increases the risk of heart failure.

Peripheral arterial disease

Peripheral arterial disease (PAD) happens when the arteries are too narrow to deliver blood to the arms, hands, legs, and feet.

Smoking can lead to PAD by causing inflammation and atherosclerosis. This can prevent oxygen-rich blood from reaching your limbs.

Abdominal aortic aneurysm

The aorta is a major artery that delivers blood throughout the body. It’s located in the abdomen.

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The chemicals in cigarette smoke can lead to increased plaque formation, inflammation, and narrowing in the aorta. As a result, the aorta may develop a bulging or weak spot called an abdominal aortic aneurysm.

The abdominal aortic aneurysm can get bigger over time. If it bursts, it can be life threatening.

What are the effects of quitting smoking on your heart?

Quitting smoking is one of the best things you can do for your heart. The effects begin soon after you stop smoking, though they be impacted by how long you have been a smoker before quitting.

The effects of quitting smoking include:

Reduced heart rate
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Smoking increases your blood pressure and heart rate. However, according to some studies, in just 20 minutes after you stop smoking, your heart rate will drop to normal levels.

Improved blood flow to your heart

Cigarette smoke contains carbon monoxide, making it difficult for adequate oxygen to reach your heart.

But after 12 hours of stopping smoking, the carbon monoxide levels in your blood will return to normal according to some studies. This will let more oxygen reach your heart.

Lower risk of heart attack

As your blood pressure returns to normal levels, your risk of heart attack will also drop. This starts within 12 to 24 hours after stopping smoking.

Lower risk of coronary heart disease
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After 1 year of quitting smoking, your risk of coronary heart disease drops by 50 percent. After 15 years, your risk will be about the same as a nonsmoker.

Lower risk of stroke

Your risk of a stroke drops after 4 years of quitting smoking. Your risk will be about the same as a nonsmoker’s risk.

How to quit smoking

Quitting smoking can be challenging. It requires hard work and effort.

Understandably, it can be difficult to know where to start. But a doctor can help create a plan that works for you.

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Common strategies include:

Nicotine replacement therapy

Nicotine replacement therapy (NRT) is used to reduce cravings and manage withdrawal symptoms. It involves a product that provides nicotine in specific amounts.

NRT is available as a:

  • patch
  • gum
  • lozenges
  • inhaler
  • nasal spray

Typically, NRT is combined with other strategies.

Smoking cessation medications
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A doctor may prescribe varenicline or bupropion, which are used to treat tobacco dependence. They’re designed to control cravings and withdrawal symptoms. In some cases, you may be able to use the medication with NRT.


A counselor who specializes in smoking cessation can help you:

  • create a smoking cessation plan
  • cope with cravings
  • manage stress caused by withdrawal
  • stay motivated

For best results, it’s recommended to try counseling in addition to medication.


Smoking cigarettes has many heart-related health risks. It can cause hypertension, arrhythmia, and atherosclerosis. Over time, these conditions can lead to more serious diseases like coronary artery disease, heart attack, stroke, heart failure, peripheral artery disease, and abdominal aortic aneurysm.

The best way to prevent these conditions is to avoid or quit smoking. If you need help quitting smoking, speak with a doctor. They can help you create a smoking cessation and improve your heart health.

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