Smoking and heart disease

The link between smoking and cardiovascular disease is a stark reality, one that presents a growing public health crisis across the globe. In regions like Sub-Saharan Africa, where over one million deaths in 2019 were attributed to cardiovascular disease, the threat is dangerously real and rising. Smoking remains a leading and preventable driver of this crisis.

Smoking damages the heart and blood vessels

Cigarette smoke contains thousands of harmful chemicals including nicotine and carbon monoxide that damage your cardiovascular system. Smoking raises heart rate and blood pressure, restricts blood vessels, and promotes the buildup of arterial plaque. This accelerates atherosclerosis (artery hardening), increasing the likelihood of heart attack, stroke, and peripheral artery disease.

Nicotine stimulates the sympathetic nervous system, increasing heart workload. Carbon monoxide reduces the blood’s oxygen-carrying capacity. Other compounds increase clotting and reduce “good” HDL cholesterol. Together, these effects significantly elevate cardiovascular risk.

Some facts about tobacco smoke

• Even light smoking just one cigarette per day carries about half the heart disease risk of smoking 20 per day. There is truly no safe level of smoking.

• For heavy smokers (25+ cigarettes daily), the risk of heart attack or stroke triples compared to nonsmokers.

• Secondhand smoke also harms the heart: nonsmokers exposed to smoke have a 25–30% higher risk of coronary heart disease and stroke.

The risks of tobacco smoking

Smokers are 2 to 4 times more likely to develop heart disease compared to nonsmokers. Smoking nearly doubles the risk of stroke. The risk is additive when combined with other factors like hypertension or high cholesterol.

Every year, smoking contributes to thousands of premature cardiovascular deaths globally. A substantial portion of smoking-related mortality is due to heart and blood vessel disease not just cancer.

Second-hand smoke is a health hazard

Non-smokers exposed to secondhand smoke also face serious risks. Their odds of developing heart disease or suffering a stroke increase by around 25–30%. Even brief exposure can disrupt blood vessel lining and promote clotting. Taken together, secondhand smoke causes tens of thousands of early deaths each year from cardiovascular causes.

Quit smoking and improve your health

Quitting smoking yields profound cardiovascular benefits:

• Within 20 minutes, blood pressure and heart rate drop.

• Within days, carbon monoxide levels in the blood normalize.

• Within 1–2 years, risk of coronary heart disease is cut in half. With continued abstinence, stroke risk also falls to near that of a non-smoker.

• Long-term quitters may achieve nearly the same heart health as those who never smoked, especially when quitting early.

Even heavy smokers benefit while it may take years for the heart disease risk to match that of someone who never smoked, the trajectory to recovery begins immediately.

Where to get help

If you’re looking to quit, reach out to healthcare providers, local smoking cessation programs, or community health services. Support whether through counseling, medications, or peer groups can dramatically improve your success.

FAQ

Does smoking cause high blood pressure?
Yes both short-term spikes (due to nicotine) and long-term elevations are well documented. Smoking is a recognized contributor to hypertension.

Can quitting smoking lower my heart disease risk?
Absolutely. Within a year, your risk of heart attack drops significantly. With more time, and especially for lighter smokers, your cardiovascular risk can approach that of someone who never smoked.

Is there a safe amount of smoking?
No. Even one cigarette per day carries substantial and disproportional risk for heart disease and stroke. Complete cessation is the only way to meaningfully lower cardiovascular risk.

Published 16th July 2025

References

National Heart, Lung, and Blood Institute Smoking and Your Heart - How Smoking Affects the Heart and Blood Vessels. Available at: https://www.nhlbi.nih.gov/health/heart/smoking

Better Health Channel Smoking and heart disease. Available at: https://www.betterhealth.vic.gov.au/health/healthyliving/smoking-and-heart-disease

American Heart Association For smokers, fatal heart attack or stroke may be first sign of cardiovascular disease. Available at: https://www.heart.org/en/news/2021/11/17/for-smokers-fatal-heart-attack-or-stroke-may-be-first-sign-of-cardiovascular-disease