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Smoking and Cardiovascular Disease

According to the American Heart Association (AHA), diseases caused by smoking kill more than 440,000 people in the United States each year. Even with antismoking campaigns and medical disclaimers in place, many people continue to smoke or start smoking every year. According to the American Cancer Society, most new smokers are children and teenagers, in many cases, replacing the smokers who quit or died prematurely from a smoking-related disease.

Smokers not only have increased risk for lung disease, including lung cancer and emphysema, but also have increased risk for heart disease, stroke, and oral cancer.

Facts about smoking and cardiovascular disease:

  • One out of every five smoking-related deaths is caused by cardiovascular disease.

  • Cigarette smoking produces a greater risk for coronary heart disease in people younger than age 50.

  • Women older than age 35 who smoke and take oral contraceptives are at much greater risk of developing a cardiovascular disease or stroke than women who do not smoke while taking oral contraceptives.

  • Cigarette smokers are two to four times more likely to develop coronary heart disease, or CHD, than nonsmokers.

  • Cigarette smoking doubles a person's risk for stroke.

  • Cigarette smokers are more than ten times as likely as nonsmokers to develop peripheral vascular disease, or PVD.

How does smoking affect the cardiovascular system?

In posing health risks on the body's cardiovascular system, smoking:

  • Causes immediate and long-term increases in blood pressure

  • Causes immediate and long-term increases in heart rate

  • Reduces cardiac output and coronary blood flow

  • Reduces the amount of oxygen that reaches the body's tissues

  • Changes the properties of blood vessels and blood cells—allowing cholesterol and other fatty substances to build up

  • Contributes to higher blood pressure and increased risk for blood clot formation

  • Damages blood vessels

  • Doubles the risk of ischemic stroke (reduced blood flow to the brain)

  • Stimulates the blood clotting process

In addition, smoking has been associated with depression and psychological distress.

What are the risks of secondhand smoke?

The CDC reports that an estimated 46,000 nonsmokers die from coronary heart disease each year as a result of exposure to secondhand tobacco smoke. Secondhand smoke is smoke that is exhaled by smokers and smoke emitted from the burning end of a lit cigarette, cigar, or pipe.

Both direct and indirect smoking exposure poses significant health hazards to pregnant women, infants, and young children. Children and infants exposed to tobacco smoke are more likely to experience ear infections and asthma, and are at a higher risk for sudden infant death syndrome (SIDS) than children and infants without the same exposure.

The following common symptoms may be associated with exposure to secondhand smoke. However, each individual may experience symptoms differently. Symptoms may include:

  • Irritation of the eyes, nose, and throat

  • Coughing

  • Excessive phlegm (mucus in the airways)

  • Chest discomfort from lung irritation

  • Chest pain, which may indicate heart disease

The symptoms of secondhand smoke may resemble other medical conditions and problems. Always consult a health care provider for a diagnosis.

Smoking and cardiovascular disease

Smoking, in addition to high cholesterol, high blood pressure, physical inactivity, obesity, and diabetes tops the list as a primary risk factor for cardiovascular disease. In fact, smoking has been classified as the single most preventable cause of premature death in the United States.

The importance of smoking cessation

According to the AHA, eliminating smoking not only reduces the risk for coronary heart disease, but also reduces the risk for repeat heart attacks and death by heart disease by half. Research also indicates that smoking cessation is crucial in the management of many contributors to heart attack, including atherosclerosis, thrombosis, coronary artery disease, and cardiac arrhythmias.

Quitting smoking is both a mental and a physical undertaking. Mentally, you should be ready and relatively stress-free. Physically, you need to commit to exercising daily and getting plenty of sleep. A person trying to quit must overcome two obstacles: a physical addiction to nicotine and a habit. The National Cancer Institute offers the following tips to help users quit using tobacco products:

  • Think about why you want to quit

  • Pick a stress-free time to quit

  • Ask for support and encouragement from family, friends, and colleagues

  • Start doing some exercise or activity each day to relieve stress and improve your health

  • Get plenty of rest

  • Eat a balanced diet

  • Join a smoking cessation program, or other support group

In some cases, smokers benefit from nicotine replacement products to help break their smoking habit. Nicotine replacement products continue to give smokers nicotine to meet their nicotine craving. However, the benefit of nicotine replacement products is the elimination of tars and poisonous gases that cigarettes emit. Pregnant or nursing women and people with other medical conditions should consult with their physician before using any nicotine replacement products. Some examples of nicotine replacement products include:

  • Nicotine chewing gum. An over-the-counter chewing gum that releases small amounts of nicotine to help reduce nicotine withdrawal symptoms.

  • Nicotine patch. An over-the-counter patch applied to the upper body once a day that releases a steady dosage of nicotine to help reduce the urge to smoke.

  • Nicotine inhaler or nasal spray. A prescription nicotine replacement product that releases nicotine to help reduce withdrawal symptoms (requires a physician's approval before use).

Non-nicotine options to quit smoking: bupropion and varenicline

Zyban (bupropion), a non-nicotine alternative to help people stop smoking, is approved by the FDA. Offered in pill form to smokers who want to quit, bupropion has been shown to alter mood transmitters in the brain that are linked to addiction. Bupropion must be prescribed by a health care provider and may not be appropriate for everyone. Consult your health care provider for more information.

Chantix (varenicline) is also a non-nicotine pill to help in smoking cessation. It was approved recently by the FDA. It targets the nicotine receptors in the brain. Varenicline attaches to the receptors and blocks nicotine from reaching them, decreasing the desire for nicotine. Varenicline may not be appropriate for everyone and you should consult your health care provider.