Smoking and Heart Disease

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Dr. Erik Beyer

A cigarette is about five inches long and less than half an inch in diameter. You might think that something so small might be harmless. But tobacco smoke contains more than 7,000 chemicals, including 250 that are known to be harmful, such as hydrogen cyanide, arsenic, benzene, chromium, and vinyl chloride. Smoking causes many different types of cancer, as well as chronic bronchitis, emphysema, diabetes, cataracts and heart disease.

People who smoke are up to six times more likely to have a heart attack compared to nonsmokers and have a greater risk of experiencing a major heart problem at least 10 years before their nonsmoking counterparts. Cigarette smokers also have a higher chance of developing atherosclerosis, the slow buildup of plaque that hardens and narrows the arteries. In addition, they may develop coronary artery disease that can lead to chest pain, heart attack, heart failure, arrhythmia (irregular heartbeat) or death.

Chemicals in tobacco smoke not only damage blood cells, but also affect how the heart works and the function and structure of blood vessels. For example, nicotine can elevate blood pressure and make blood clots form more easily.

Smokers aren’t the only ones at risk for heart disease from tobacco smoke. The heart and blood vessels also are affected by secondhand smoke, which comes from the smoke exhaled by a smoker or the burning end of a cigarette, cigar or pipe. According to the American Heart Association, each year approximately 22,700 to 69,600 premature deaths are due to heart and blood vessel diseases caused by environmental tobacco smoke. This type of smoke also increases the coronary heart disease risk for children and teens because it lowers HDL cholesterol, hurts heart tissue and elevates blood pressure.


Stopping smoking isn’t easy. But quitting reduces the risk of heart disease right away and the benefits of being smoke-free increase over time. Heart rate and blood pressure begin to return to normal immediately and within hours the carbon monoxide level in the blood starts to decrease. A few weeks later circulation improves, and there is less coughing and wheezing. Lung function increases in a few months and by one year after quitting the chances of developing heart disease drop by more than 50 percent. After several years, the risk will be near that of someone who has never smoked.

Regardless of how long, how often, or how much you have smoked, quitting will help. Even if you already have heart disease, not smoking can lower your risk of another heart attack, other chronic diseases or death. For people undergoing surgery, chemotherapy or other treatments, quitting can help improve the body’s ability to heal and respond to therapy.

Dr. Erik Beyer is a cardiothoracic surgeon at Florida Medical Center.


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