SMOKING AND THE HEART

Most people know that smoking is bad for your lungs and can cause
cancer. However, fewer may be aware of the effects of smoking
on the heart and the circulatory system—the arteries and veins
that carry the blood throughout the body. The May 7, 2008, issue of JAMA
includes an article reporting that quitting greatly reduces the excess death
rates due to smoking in women. This Patient Page is based on one published
in the July 2, 2003, issue of JAMA.

SMOKING, BLOOD VESSELS, AND DEATH

Cigarette smoking is the main preventable cause of premature death in the
developed world. It accounts for nearly 440 000 deaths every year in the United
States.
When you smoke, toxic chemicals from tobacco enter your bloodstream. Some of
these chemicals send signals to your heart to beat harder and faster. Smoking also
causes blood vessels to constrict (become more narrow), forcing blood to travel
through a smaller space. Both of these effects cause high blood pressure. Smoking
also lowers high-density lipoprotein (good cholesterol) in your body and increases
the likelihood of plaques (fatty buildups) collecting on the inside of blood vessels, a
condition called atherosclerosis (hardening of the arteries). Smoking also increases
the risk of thrombosis (blood clots blocking a blood vessel). Over time, these
effects increase the risk of having a myocardial infarction (heart attack).
Smoking can also increase the risk of having a stroke (sudden blockage of blood
circulation in the brain). A stroke is usually caused by a blood clot getting lodged in
the blood vessels supplying the brain with blood and oxygen. When this happens,
brain cells begin to die. This can cause permanent brain damage or even death.
Women who smoke and use oral contraceptives (birth control pills) are at a much
higher risk of developing heart disease or having a stroke than women taking oral
contraceptives who do not smoke.

BENEFITS OF QUITTING SMOKING
• Reduces risk of heart disease by almost half and reduces chances of having heartrelated
problems if you already have heart disease
• Reduces risk of having a blood clot
• Reduces chances of developing several different kinds of cancer
• Reduces risk of developing emphysema, a serious lung disease that impairs breathing
• Improves stamina for exercising and participating in sports
• Improves senses of taste and smell
Quitting smoking can be a difficult process but is well worth the effort. A number
of prescription and nonprescription aids are available to help you quit. If you are still
smoking, talk with your doctor about it!