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Smoking is the leading cause of preventable death in the world. According to the CDC, diseases caused by smoking kill more than 480,000 people in the U.S. each year. The CDC also states that smokers are 2 to 4 times more likely to develop heart disease and stroke. Despite the known dangers, many people continue to smoke or start smoking every year. One out of 5 deaths of Americans is related to smoking, and it kills more Americans each year than suicides, homicides, AIDS, and car accidents combined. According to the CDC, 9 in 10 new smokers are children and teens. In many cases, they are 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. Almost one-third of all cancers are related to smoking. Smoking kills more women each year than breast cancer. Smoking also contributes to the development of diabetes, tuberculosis, immune system disease, and male impotence.

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 an increased risk for blood clot formation

  • Damages blood vessels

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

Smoking has also been associated with depression and psychological distress.

What are the risks of secondhand smoke?

The CDC reports that an estimated 34,000 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. Secondhand smoke can also cause lung cancer and stroke.  

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

These common symptoms may be linked to exposure to secondhand smoke:

  • Irritation of the eyes, nose, and throat

  • Coughing

  • Excessive mucus in the airways (phlegm)

  • Chest discomfort from lung irritation

  • Chest pain, which may mean heart disease

The symptoms of secondhand smoke exposure may look like other health conditions. Always see your healthcare provider for a diagnosis.

Creating a smoke-free environment indoors and outdoors protects nonsmokers from secondhand smoke exposure. 

Smoking and cardiovascular disease

Smoking is one of the main risk factor for heart disease. Other risk factors are high cholesterol, high blood pressure, physical inactivity, obesity, and diabetes. In fact, smoking is the single most preventable cause of premature death in the U.S.

Importance of smoking cessation

Eliminating smoking has both short-term and long-term rewards. Within weeks of quitting, blood pressure lowers and blood circulation improves. One year after quitting, the risk for heart disease from smoking decreases by half. Five years after quitting, your risk of certain cancers caused by smoking decreases by half. Research also shows that stopping smoking is key to manage the many contributors to heart attack. These include atherosclerosis, thrombosis, coronary artery disease, and cardiac arrhythmias.

Getting help to quit

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. You must overcome 2 obstacles: a physical addiction to nicotine and a habit. The American Cancer Society offers these 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 and friends

  • Start a daily exercise or activity 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 that they don't have the tars and poisonous gases that cigarettes give off. Pregnant or nursing women and people with other medical conditions should talk with their healthcare provider before using any nicotine replacement products. Some examples of nicotine replacement products include:

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

  • Nicotine patch. An OTC patch applied to the upper body once a day. It releases a steady dose of nicotine to help reduce the urge to smoke.

  • Nicotine lozenge. A lozenge that dissolves in the mouth. It releases small amounts of nicotine to reduce any cravings to smoke. 

  • Nicotine inhaler or nasal spray. A prescription nicotine replacement product. It releases nicotine to help reduce withdrawal symptoms (needs a health care provider's approval before use).

Non-nicotine options to quit smoking

Bupropion, a non-nicotine alternative to help people stop smoking, was approved in 1997 by the FDA. Offered in pill form to smokers who want to quit, bupropion has been shown to change mood transmitters in the brain that are linked to addiction. Bupropion must be prescribed by a healthcare provider. It may not be right for everyone. Talk with your healthcare provider for more information.

Varenicline is also a non-nicotine pill to help with quitting smoking. It was approved by the FDA in 2006. It is the first medicine that targets the nicotine receptors in the brain. Varenicline attaches to the receptors and blocks nicotine from reaching them. This decreases the desire for nicotine. Varenicline may not be right for everyone. Talk with your healthcare provider to see if this is a good option for you.

Electronic cigarettes (e-cigarettes or vaping)

E-cigarettes are a popular option among teens. Vaping means inhaling a vaporized, heated nicotine-containing liquid instead of  smoking cigarettes. It's also used to help quit smoking. Many people think this is a healthier alternative to traditional combustible cigarettes or cigars. The long-term health effects are not known but some of the products used in the vapor are believes to be cancer-causing and have similar cardiovascular effects if the levels of nicotine become high enough. E-cigarettes may appeal to teens who would not choose to smoke conventional cigarettes. If children ingest the fluid in e-cigarettes, it can be toxic and deadly. There is not enough evidence to know the health impacts of second-hand vapor exposure from being around someone smoking an e-cigarette, but there is concern that there may be bad effects that should be monitored. 

Online Medical Reviewer: Lu Cunningham
Online Medical Reviewer: Mandy Snyder APRN
Online Medical Reviewer: Steven Kang MD
Date Last Reviewed: 3/1/2019
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