Tobacco use has serious effects on the health of users. In fact, tobacco use remains the leading preventable cause of disease and death in the United States, leading to more than 480,000 deaths each year.

Different tobacco products, however, pose varying levels of health risk to users. Combustible products that burn tobacco, like a cigarette, are the most harmful to a user’s health, while noncombustible products, such as e-cigarettes, may be less harmful. However, no tobacco product is considered safe.

Health Effects of Smoking

Cigarettes are responsible for the vast majority of all tobacco-related disease and death in the U.S. Smokers are exposed to a toxic mix of over 7,000 chemicals when they inhale cigarette smoke, the consequences of which can threaten their health in many ways.

If you or a loved one are among the 34 million U.S. adults who smoke cigarettes in this country and want to quit, there are resources to help you on your journey to living a smoke-free life.

COVID-19 and Smoking

Am I at risk for serious complications from COVID-19 if I smoke cigarettes?

Yes. Data show that when compared to never smokers, cigarette smoking increases the risk of more severe illness from COVID-19, which could result in hospitalization, the need for intensive care, or even death. Smoking cigarettes can cause inflammation and cell damage throughout the body, and can weaken your immune system, making it less able to fight off disease.

There’s never been a better time to quit smoking. If you need resources to help you quit smoking, the FDA has supportive tips and tools to help you get closer to quitting for good.

If I vape tobacco or nicotine am I at risk for complications from COVID-19?

E-cigarette use can expose the lungs to toxic chemicals, but whether those exposures increase the risk of COVID-19 or the severity of COVID-19 outcomes is not known. However, many e-cigarette users are current or former smokers, and cigarette smoking increases the risk of respiratory infections, including pneumonia.

• The nicotine found in cigarettes and in smokeless tobacco is a powerful, addictive drug that acts on several parts of the body. Once addicted, it becomes difficult, but not impossible, to quit using smokeless tobacco or to stop smoking.
• The use of tobacco products is not only addicting, but is directly related to a number of health problems and diseases. A few of the oral health problems smokers or smokeless tobacco users can develop are —
  • bad breath
  • brown, stained teeth
  • ground-down teeth
  • black hairy tongue
  • gum disease and loss of teeth receding gums
  • cancers of the cheek, esophagus, lip, palate and tongue
• Some of the harmful ingredients found in tobacco are —
  • arsenic
  • formaldehyde
  • dirt
  • fertilizer
  • soot
  • pesticides
  • cyanide manure
  • nicotine
  • dead bugs
• At least 19 different types of cancer-causing substances, called nitrosamines, are found in tobacco products.
• Oral cancer is serious. When it spreads to the lymph nodes in the neck, it is often deadly.
• Smokeless tobacco is not a harmless alternative to smoking. It is just as hazardous to your health as cigarettes. Protect your health; avoid all tobacco products.
• The risk of developing lung cancer is 10 times greater for smokers than for non- smokers. Also, breathing second-hand smoke (someone else’s smoke) can be as dangerous as smoking.
• Once you stop using tobacco products, your blood pressure, pulse rate and skin temperature will return to normal within 20 minutes. Within eight hours, high levels of carbon monoxide in your blood will return to normal and, within a few weeks, your circulation will improve, your sense of taste and smell will improve, and you will have fewer colds and more energy. It is never too late to stop!​​​​​​​

What Is Nicotine?

Nicotine is a highly addictive chemical compound present in a tobacco plant. All tobacco products contain nicotine, including cigarettes, non-combusted cigarettes (commonly referred to as “heat-not-burn tobacco products” or “heated tobacco products”), cigars, smokeless tobacco (such as dip, snuff, snus, and chewing tobacco), hookah tobacco, and most e-cigarettes.

Using any tobacco product can lead to nicotine addiction. This is because nicotine can change the way the brain works, causing cravings for more of it.

Some tobacco products, like cigarettes, are designed to deliver nicotine to the brain within seconds, making it easier to become dependent on nicotine and more difficult to quit. While nicotine naturally occurs in the tobacco plant itself, some tobacco products contain additives that may make it easier for your body to absorb more nicotine.

What Makes Tobacco Use Harmful?

Nicotine is what keeps people using tobacco products. However, it’s the thousands of chemicals contained in tobacco and tobacco smoke that make tobacco use so deadly. Some of these chemicals, known to cause lung damage, are also found in some e-cigarette aerosols.

This toxic mix of chemicals—not nicotine—cause the serious health effects among those who use tobacco products, including fatal lung diseases, like chronic obstructive pulmonary disease (COPD) and cancer.

Tobacco products containing nicotine pose different levels of health risk to adult users. Combustible products, or products that burn tobacco, are the most harmful. An example of a combustible product is cigarettes, which deliver more than 7,000 chemicals along with nicotine that makes it hard to quit.

FDA-approved nicotine replacement therapies (NRTs), such as gums and lozenges, are the least harmful. Noncombustible products, such as heat-not-burn tobacco products, smokeless tobacco, and e-cigarettes, fall somewhere in between combustible products and NRTs.

If you’re an adult who currently doesn’t use tobacco products, we strongly encourage you to stay tobacco-free. If you’re an adult who currently uses tobacco products, there are resources to help you quit.

To learn about the additional harms tobacco can have on young people and their developing brains, read “Why Can’t My Teen Quit Smoking or Vaping?”

What Are Nicotine Replacement Therapies (NRTs) and How Can They Help?

FDA-approved nicotine replacement therapies, also known as NRTs, are safe and effective products that contain nicotine and are designed to help adults quit smoking by delivering small amounts of nicotine to the brain without the toxic chemicals found in cigarette smoke.

NRTs such as nicotine skin patches, gum, and lozenges can help you through the early part of quitting by relieving cravings and lessening nicotine withdrawal symptoms. When used properly, NRTs are a safe and effective way to help quit smoking and can double the chances of successfully quitting cigarettes.

While there are no FDA-approved NRTs for youth use, talk to your health care provider about treatment options for youth.

Where Do E-Cigarettes Fall on the Continuum of Risk?

FDA is committed to protecting the public health of all Americans while regulating an addictive product that carries health risks. We’re conducting ongoing research on potentially less harmful forms of nicotine delivery for adults, such as electronic nicotine delivery systems (ENDS), or e-cigarettes. Though more research on both individual and population health effects is needed, many studies suggest e-cigarettes and noncombustible tobacco products may be less harmful than combustible cigarettes.

A 2020 Cochrane Library review of ENDS for smoking cessation found:

• ENDS may help more people to stop smoking for six months or longer than using NRTs or nicotine free e-cigarettes.
• ENDS may increase quit rates compared to no support, or behavioral support alone.
• The overall incidence of serious adverse effects related to ENDS is low.

While these findings back up anecdotal reports, there is not yet enough evidence to support claims that e-cigarettes and other ENDS are effective tools for quitting smoking. According to the findings, the effects are particularly unclear when it comes to newer types of e-cigarettes that have better nicotine delivery, and the effect of ENDS when combined with an NRT.

To date, no e-cigarette has been approved as a cessation device or authorized to make a modified risk claim, and more research is needed to understand the potential risks and benefits these products may offer adults who use tobacco products.

Is Nicotine Hazardous Waste?

Yes. Nicotine, including nicotine salt, is listed by the Environmental Protection Agency (EPA) as an acute hazardous waste. E-cigarettes and e-liquid waste should be disposed of safely and properly.

Why Can’t My Teen Quit Smoking or Vaping?

Because their brains are still developing, young people have a higher risk of becoming addicted to the nicotine in tobacco products than adults.

Many teens don’t understand how easy it is to become addicted to tobacco products. The younger a person is when they start using tobacco, the more likely they are to become addicted.

Nicotine exposure during adolescence can disrupt normal brain development.

Because of nicotine’s powerfully addictive nature and major effects on the developing brain, no tobacco products are safe for youth to use.

Will Smoking or Using Tobacco Products Containing Nicotine Hurt My Baby?

Nicotine can cross the placenta when a pregnant person uses tobacco products. This can negatively impact the baby, including, but not limited to: premature labor; low birth weight; respiratory failure at birth; and even sudden infant death syndrome (SIDS).

People who use tobacco products can experience negative health effects on their reproductive health, their pregnancies, and their babies. If you use tobacco products and are considering having a child, consult your doctor and learn more about how you can quit smoking.

Is FDA Lowering the Levels of Nicotine in Cigarettes?

Lowering nicotine in cigarettes to a minimally or non-addictive level through the creation of a potential nicotine product standard could decrease the chances that future generations become addicted to cigarettes, and could make it easier for more currently addicted smokers to quit.

On March 15, 2018, FDA issued an advance notice of proposed rulemaking (ANPRM) seeking public comment on issues and questions related to such a potential nicotine product standard. FDA is constantly gathering new evidence and considering evolving data regarding tobacco products and use, and continues to consider a product standard that would require manufacturers to limit the amount of nicotine in cigarettes and certain other combusted tobacco products to a level that would render them minimally addictive or non-addictive for most people. On June 21, 2022, the potential nicotine product standard was included in the Spring 2022 Unified Agenda.

Many of the health problems caused by tobacco use are well known. Cigarette smoking causes heart disease, lung and esophageal cancer, and chronic lung disease. Additionally, several research studies have identified smoking as a risk factor for osteoporosis and bone fracture. According to the Centers for Disease Control and Prevention, more than 16 million Americans are living with a disease caused by smoking.

Facts about osteoporosis

Osteoporosis is a condition in which bones weaken and are more likely to fracture. Fractures from osteoporosis can result in pain and disability. In the United States, more than 53 million people either already have osteoporosis or are at high risk due to low bone mass.

In addition to smoking, risk factors for developing osteoporosis include:

• Thinness or small frame.
• Family history of the disease.
• Being postmenopausal and particularly having had early menopause.
• Abnormal absence of menstrual periods (amenorrhea).
• Prolonged use of certain medications, such as those used to treat lupus, asthma, thyroid deficiencies, and seizures.
• Low calcium intake.
• Lack of physical activity.
• Excessive alcohol intake.

Osteoporosis can often be prevented. It is known as a “silent” disease because, if undetected, bone loss can progress for many years without symptoms until a fracture occurs. It has been called a childhood disease with old age consequences because building healthy bones in youth can help prevent osteoporosis and fractures later in life. However, it is never too late to adopt new habits for healthy bones.

Smoking and osteoporosis

Cigarette smoking was first identified as a risk factor for osteoporosis decades ago. Studies have shown a direct relationship between tobacco use and decreased bone density. Analyzing the impact of cigarette smoking on bone health is complicated. It is hard to determine whether a decrease in bone density is due to smoking itself or to other risk factors common among people who smoke. For example, in many cases people who smoke are thinner than nonsmokers, tend to drink more alcohol, may be less physically active, and have poor diets. Women who smoke also tend to have an earlier menopause than nonsmokers. These factors place many people who smoke at an increased risk for osteoporosis apart from their tobacco use.

In addition, studies on the effects of smoking suggest that smoking increases the risk of having a fracture. As well, smoking has been shown to have a negative impact on bone healing after fracture.

Osteoporosis management strategies

Start by quitting: The best thing smokers can do to protect their bones is to quit smoking. Smoking cessation, even later in life, may help limit smoking-related bone loss. Many resources are available to help you stop smoking, some of which are listed at the end of this fact sheet.

Eat a well-balanced diet rich in calcium and vitamin D: Good sources of calcium include low-fat dairy products; dark green, leafy vegetables; and calcium-fortified foods and beverages. Supplements can help ensure that you get adequate amounts of calcium each day, especially in people with a proven milk allergy. The Institute of Medicine recommends a daily calcium intake of 1,000 mg (milligrams) for men and women up to age 50. Women over age 50 and men over age 70 should increase their intake to 1,200 mg daily.

Vitamin D plays an important role in calcium absorption and bone health. Food sources of vitamin D include egg yolks, saltwater fish, and liver. Many people, especially those who are older, may need vitamin D supplements to achieve the recommended intake of 600 to 800 IU (International Units) each day.

Exercise for your bone health: Like muscle, bone is living tissue that responds to exercise by becoming stronger. Weight-bearing and resistance exercises are the best exercises for bone. Examples include of weight-bearing exercises include walking, climbing stairs, and dancing. Resistance exercises – such as lifting weights – can also make bones stronger.

Avoid excessive use of alcohol: Chronic alcohol use has been linked to an increase in fractures of the hip, spine, and wrist. Drinking too much alcohol interferes with the balance of calcium in the body. It also affects the production of hormones, which have a protective effect on bone, and of vitamins, which we need to absorb calcium. Excessive alcohol consumption also can lead to more falls and related fractures.

Talk to your doctor about a bone density test: A bone mineral density (BMD) test measures bone density at various sites of the body. This painless test can detect osteoporosis before a fracture occurs and can predict one’s chances of fracturing in the future. If you currently or used to smoke, you may want to ask your health care provider whether you are a candidate for a BMD test, which can help determine whether medication should be considered.

See if medication is an option for you: There is no cure for osteoporosis. However, several medications are available to prevent and treat the disease in postmenopausal women and in men. Your doctor can help you decide whether medication might be right for you.

Smoking affects the entire body, increasing the risk of many life-threatening diseases—including lung cancer, emphysema, and heart disease. Smoking also contributes to many cancers and diseases of the digestive system. Estimates show that about one-fifth of all adults smoke, and each year at least 443,000 Americans die from diseases caused by cigarette smoking.

What is the digestive system?

The digestive system is made up of the gastrointestinal (GI) tract—also called the digestive tract—and the liver, pancreas, and gallbladder. The GI tract is a series of hollow organs joined in a long, twisting tube from the mouth to the anus. The hollow organs that make up the GI tract are the mouth, esophagus, stomach, small intestine, large intestine—which includes the colon and rectum—and anus. Food enters the mouth and passes to the anus through the hollow organs of the GI tract. The liver, pancreas, and gallbladder are the solid organs of the digestive system. The digestive system helps the body digest food, which includes breaking food down into nutrients the body needs. Nutrients are substances the body uses for energy, growth, and cell repair.

Does smoking increase the risk of cancers of the digestive system?

Smoking has been found to increase the risk of cancers of the

• mouth
• esophagus
• stomach
• pancreas

Research suggests that smoking may also increase the risk of cancers of the

• liver
• colon
• rectum

What are the other harmful effects of smoking on the digestive system?

Smoking contributes to many common disorders of the digestive system, such as heartburn and gastroesophageal reflux disease (GERD), peptic ulcers, and some liver diseases. Smoking increases the risk of Crohn’s disease, colon polyps, and pancreatitis, and it may increase the risk of gallstones.

How does smoking affect heartburn and GERD?

Smoking increases the risk of heartburn and GERD. Heartburn is a painful, burning feeling in the chest caused by reflux, or stomach contents flowing back into the esophagus—the organ that connects the mouth to the stomach. Smoking weakens the lower esophageal sphincter, the muscle between the esophagus and stomach that keeps stomach contents from flowing back into the esophagus. The stomach is naturally protected from the acids it makes to help break down food. However, the esophagus is not protected from the acids. When the lower esophageal sphincter weakens, stomach contents may reflux into the esophagus, causing heartburn and possibly damaging the lining of the esophagus.

GERD is persistent reflux that occurs more than twice a week. Chronic, or long lasting, GERD can lead to serious health problems such as bleeding ulcers in the esophagus, narrowing of the esophagus that causes food to get stuck, and changes in esophageal cells that can lead to cancer.

How does smoking affect peptic ulcers?

Smoking increases the risk of peptic ulcers. Peptic ulcers are sores on the inside lining of the stomach or duodenum, the first part of the small intestine. The two most common causes of peptic ulcers are infection with a bacterium called Helicobacter pylori (H. pylori) and long-term use of nonsteroidal anti-inflammatory drugs such as aspirin and ibuprofen.

Researchers are studying how smoking contributes to peptic ulcers. Studies suggest that smoking increases the risk of H. pylori infection, slows the healing of peptic ulcers, and increases the likelihood that peptic ulcers will recur. The stomach and duodenum contain acids, enzymes, and other substances that help digest food. However, these substances may also harm the lining of these organs. Smoking has not been shown to increase acid production. However, smoking does increase the production of other substances that may harm the lining, such as pepsin, an enzyme made in the stomach that breaks down proteins. Smoking also decreases factors that protect or heal the lining, including

• blood flow to the lining
• secretion of mucus, a clear liquid that protects the lining from acid
• production of sodium bicarbonate—a saltlike substance that neutralizes acid—by the pancreas

The increase in substances that may harm the lining and decrease in factors that protect or heal the lining may lead to peptic ulcers.

How does smoking affect liver disease?

Smoking may worsen some liver diseases, including

• primary biliary cirrhosis, a chronic liver disease that slowly destroys the bile ducts in the liver
• nonalcoholic fatty liver disease (NAFLD), a condition in which fat builds up in the liver

Researchers are still studying how smoking affects primary biliary cirrhosis, NAFLD, and other liver diseases.

Liver diseases may progress to cirrhosis, a condition in which the liver slowly deteriorates and malfunctions due to chronic injury. Scar tissue then replaces healthy liver tissue, partially blocking the flow of blood through the liver and impairing liver functions.

The liver is the largest organ in the digestive system. The liver carries out many functions, such as making important blood proteins and bile, changing food into energy, and filtering alcohol and poisons from the blood. Research has shown that smoking harms the liver’s ability to process medications, alcohol, and other toxins and remove them from the body. In some cases, smoking may affect the dose of medication needed to treat an illness.

How does smoking affect Crohn’s disease?

Current and former smokers have a higher risk of developing Crohn’s disease than people who have never smoked.

Crohn’s disease is an inflammatory bowel disease that causes irritation in the GI tract. The disease, which typically causes pain and diarrhea, most often affects the lower part of the small intestine; however, it can occur anywhere in the GI tract. The severity of symptoms varies from person to person, and the symptoms come and go. Crohn’s disease may lead to complications such as blockages of the intestine and ulcers that tunnel through the affected area into surrounding tissues. Medications may control symptoms. However, many people with Crohn’s disease require surgery to remove the affected portion of the intestine.

Among people with Crohn’s disease, people who smoke are more likely to

• have more severe symptoms, more frequent symptoms, and more complications
• need more medications to control their symptoms
• require surgery
• have symptoms recur after surgery

The effects of smoking are more pronounced in women with Crohn’s disease than in men with the disease.

Researchers are studying why smoking increases the risk of Crohn’s disease and makes the disease worse. Some researchers believe smoking might lower the intestines’ defenses, decrease blood flow to the intestines, or cause immune system changes that result in inflammation. In people who inherit genes that make them susceptible to developing Crohn’s disease, smoking may affect how some of these genes work.

How does smoking affect colon polyps?

People who smoke are more likely to develop colon polyps. Colon polyps are growths on the inside surface of the colon or rectum. Some polyps are benign, or noncancerous, while some are cancerous or may become cancerous.

Among people who develop colon polyps, those who smoke have polyps that are larger, more numerous, and more likely to recur.

How does smoking affect pancreatitis?

Smoking increases the risk of developing pancreatitis. Pancreatitis is inflammation of the pancreas, which is located behind the stomach and close to the duodenum. The pancreas secretes digestive enzymes that usually do not become active until they reach the small intestine. When the pancreas is inflamed, the digestive enzymes attack the tissues of the pancreas.

How does smoking affect gallstones?

Some studies have shown that smoking may increase the risk of developing gallstones. However, research results are not consistent and more study is needed.

Gallstones are small, hard particles that develop in the gallbladder, the organ that stores bile made by the liver. Gallstones can move into the ducts that carry digestive enzymes from the gallbladder, liver, and pancreas to the duodenum, causing inflammation, infection, and abdominal pain.

Can the damage to the digestive system from smoking be reversed?

Quitting smoking can reverse some of the effects of smoking on the digestive system. For example, the balance between factors that harm and protect the stomach and duodenum lining returns to normal within a few hours of a person quitting smoking. The effects of smoking on how the liver handles medications also disappear when a person stops smoking. However, people who stop smoking continue to have a higher risk of some digestive diseases, such as colon polyps and pancreatitis, than people who have never smoked.

Quitting smoking can improve the symptoms of some digestive diseases or keep them from getting worse. For example, people with Crohn’s disease who quit smoking have less severe symptoms than smokers with the disease.

Eating, Diet, and Nutrition

Eating, diet, and nutrition can play a role in causing, preventing, and treating some of the diseases and disorders of the digestive system that are affected by smoking, including heartburn and GERD, liver diseases, Crohn’s disease, colon polyps, pancreatitis, and gallstones. More information about eating, diet, and nutrition and these conditions can be found on the Digestive Diseases A-Z list.

Points to Remember

• Smoking has been found to increase the risk of cancers of the mouth, esophagus, stomach, and pancreas. Research suggests that smoking may also increase the risk of cancers of the liver, colon, and rectum.
• Smoking increases the risk of heartburn and gastroesophageal reflux disease (GERD).
• Smoking increases the risk of peptic ulcers.
• Smoking may worsen some liver diseases, including primary biliary cirrhosis and nonalcoholic fatty liver disease (NAFLD).
• Current and former smokers have a higher risk of developing Crohn’s disease than people who have never smoked.
• People who smoke are more likely to develop colon polyps.
• Smoking increases the risk of developing pancreatitis.
• Some studies have shown that smoking may increase the risk of developing gallstones. However, research results are not consistent and more study is needed.
• Quitting smoking can reverse some of the effects of smoking on the digestive system.

Does Smoking Contribute to Heart Disease?

Yes, smoking cigarettes can harm nearly any part of your body, including your heart and blood vessels (cardiovascular system).

When breathed in, the toxic mix of more than 7,000 chemicals in cigarette smoke can interfere with important processes in your body that keep it functioning normally. One of these processes is the delivery of oxygen-rich blood to your heart and the rest of your body.

When you breathe, your lungs take in oxygen and deliver it to your heart, which pumps this oxygen-rich blood to the rest of your body through the blood vessels.

But when you breathe in cigarette smoke, the blood that is distributed to the rest of the body becomes contaminated with the smoke’s chemicals. These chemicals can damage your heart and blood vessels, which can lead to cardiovascular disease (CVD)—the leading cause of all deaths in the United States.

What Cardiovascular Conditions Can Result from Smoking?

Smoking cigarettes can permanently damage your heart and blood vessels. This can lead to cardiovascular disease.

Cardiovascular disease refers to multiple conditions affecting the heart and/or blood vessels. Some of these conditions include:

• Coronary heart disease, or the narrowing of blood vessels carrying blood to the heart.
• Hypertension (high blood pressure).
• Heart attack.
• Stroke.
• Aneurysms (a bulge or weakness in an artery).
• Peripheral artery disease.

Smoking cigarettes can also cause CVD by changing your blood chemistry.

These changes in blood chemistry can cause plaque—a waxy substance comprised of cholesterol, scar tissue, calcium, fat, and other material—to build up in your arteries, the major blood vessels that carry blood from your heart to your body. This plaque buildup can lead to a disease called atherosclerosis.

When the chemicals in cigarette smoke cause atherosclerosis and thickened blood in the arteries, it becomes more difficult for blood cells to move through arteries and other blood vessels to get to vital organs like the heart and brain. This can create blood clots and ultimately lead to a heart attack or stroke, even death.

Other rare but serious cardiovascular conditions that can be caused by smoking include:

• Peripheral artery disease (and peripheral vascular disease): A condition in which the narrowing of blood vessels results in insufficient blood flow to arms, legs, hands, and feet. Smoking is the leading preventable cause of this condition, which can result in amputation.
• Abdominal aortic aneurysm: A bulge that is formed in an area of the aorta—the main artery that distributes blood through the body—that sits in the abdomen. When an abdominal aortic aneurysm bursts, it can result in sudden death. More women than men die from aortic aneurysms, and nearly all deaths from this condition are caused by smoking.

How Many People Die Each Year from Cardiovascular Disease Caused by Smoking?

According to the American Heart Association, cardiovascular disease accounts for about 800,000 U.S. deaths every year, making it the leading cause of all deaths in the United States. Of those, nearly 20 percent are due to cigarette smoking.

Can Secondhand Smoke Increase My Risk for Coronary Heart Disease?

While smoking is a direct cause of cardiovascular disease and death, you could be at risk even if you don’t smoke cigarettes.

People who don’t smoke cigarettes but who are regularly exposed to secondhand smoke have a 25 to 30 percent increased risk of coronary heart disease than those not exposed.

In fact, 30,000 U.S. coronary heart disease deaths per year are caused by secondhand smoke. Secondhand smoke exposure also increases your risk of having a heart attack or stroke.

Can Quitting Smoking Improve My Heart Health?

The best way to safeguard your heart from smoking-related disease and death is to never start using cigarettes. But if you do smoke cigarettes, the earlier you can quit, the better.
Quitting smoking benefits your heart and cardiovascular system now and in the future:

• Twenty minutes after you quit smoking, your heart rate drops.
• Just 12 hours after quitting smoking, the carbon monoxide level in your blood drops to normal, allowing more oxygen to vital organs like your heart.
• Within four years of quitting, your risk of stroke drops to that of lifetime nonsmokers.

How Can I Quit Smoking to Protect My Heart?

Although quitting smoking is difficult, it is achievable.

FDA-approved nicotine replacement therapy (NRT) may be able to help you on your quit journey. NRTs are proven safe and effective to help you quit smoking by delivering measured amounts of nicotine without the toxic chemicals found in cigarette smoke.

Many people who smoke find that FDA-approved NRTs helps them get through the first steps of quitting by reducing cravings and symptoms of withdrawal.

If you smoke cigarettes and are concerned about your heart and cardiovascular health, consult with your health care provider about NRTs or other ways to quit to help protect your heart.

Every organ in the human body serves an important purpose in keeping it running and in prime condition. Most healthy people are not cognizant of their organs—like lungs—on a daily basis, because they are able to breathe without difficulty and perform their daily tasks without major effort. But damage to these vital organs can cause serious disease, and sometimes death. Cigarettes can harm the tissue of the lungs, impeding their ability to function properly, and can increase the risk for conditions such as emphysema, lung cancer, and chronic obstructive pulmonary disease (COPD).

The primary function of your lungs is to deliver oxygen-rich blood to the rest of your body from the air you breathe in and expel carbon dioxide as waste when you exhale. While no tobacco product is safe, combustible products—or those you must light on fire to use, like cigarettes—are especially damaging to the lungs.

Smoking and Your Lungs

Cigarette smoking can cause immediate damage to your health. Each puff of cigarette smoke contains a mix of over 7,000 chemicals. When you breathe this in, the smoke hits your lungs very quickly, and the blood that is then carried to the rest of your body contains these toxic chemicals. Because tobacco smoke contains carbon monoxide, this deadly gas displaces the oxygen in your blood, depriving your organs of the oxygen they need.

Other chemicals found in cigarette smoke include acrolein, which can cause irreversible lung damage, and even in low amounts, it can cause a sore throat in 10 minutes. Cigarettes may also contain bronchodilators, or chemicals that are meant to open up the airways of the lungs and could increase the amount of dangerous chemicals absorbed by the lungs.

Cigarette smoking can have major consequences on the lungs at all ages. Babies whose mothers smoked during pregnancy may have lungs that develop abnormally, and teens who smoke cigarettes can develop smaller, weaker lungs that never grow to full size and never perform at their peak capacity. In addition, smoking can destroy the cilia—or tiny hairs in your airway that keep dirt and mucus out of your lungs. When these cilia are destroyed, you develop what is known as “smoker’s cough,” a chronic cough that is often seen in long-term or daily smokers.

Lung damage due to smoking does not end there. 8 out of 10 cases of chronic obstructive pulmonary disease (or COPD) are caused by smoking. People with COPD experience difficulty breathing and eventually die because of a lack of air. There is no cure for COPD. Furthermore, nearly all lung cancer—the top cause of cancer death in both men and women— is caused by smoking, and smokers are 20 times more likely to develop lung cancer than nonsmokers. In addition to lung cancer, smoking can lead to other respiratory cancers, such as:

• The oropharynx (the back of the mouth, including parts of the tongue, the soft palate, the side and back of the throat, and the tonsils)
• Larynx (the “voice box”)
• Trachea (the “windpipe”)
• Bronchus (one of two large airways that connect the trachea to the lungs)

Not Just Cigarettes: Other Tobacco Products and Lung Health

While cigarettes—given their high rate of use, addictive nature, and toxic mix of chemicals—are the most dangerous tobacco product, any tobacco product you inhale could cause lung damage. Cigar smoking can increase the risk of COPD, and lead to cancers of the lung, oral cavity, and larynx, among other cancers.

Electronic Nicotine Delivery Systems (ENDS), like e-cigarettes, are still relatively new tobacco products and are still being evaluated for their impacts on health. But e-cigarette use—or “vaping”—may be harmful to your lungs. Some e-cigarette aerosols have been found to contain some of the same chemicals in cigarettes, including the lung irritant acrolein, and formaldehyde, which may adversely affect the throat.Flavoring chemicals are considered safe for eating, but could be harmful when inhaled. Buttery flavors like caramel, toffee, and chocolate contain the chemicals diacetyl and acetoin, which can be harmful to your lungs. Additionally, fruit flavored e-cigarettes can have higher concentrations of a chemical called acrylonitrile, which is a known respiratory irritant.

How You Can Protect Your Lungs from Tobacco

Your lungs are one of your body’s filtration systems, taking in air from the atmosphere, adding oxygen to the blood for circulation throughout the body, and expelling excess carbon dioxide. When tobacco is inhaled, it interferes with this delicate balance. The best way to ensure lung health is to never start using tobacco, but if you are an addicted smoker, the sooner you quit, the sooner your lungs can begin to heal. Quitting smoking can lower the risk of getting cancer. In fact, when you quit smoking, your risk of:

• Cancer of the larynx is reduced immediately;
• Lung cancer drops by 50 percent 10 years after quitting;
• Mouth and throat cancers drop by 50% five years after quitting.

Anyone who quits smoking will experience better overall health. Just 12 hours after quitting, the carbon monoxide level in your blood drops to normal, allowing more oxygen to circulate to your organs.

How Does Smoking Affect Fertility, Hormone Production, and Conception When Trying to Get Pregnant?

Smoking cigarettes can have negative health effects on fertility, making it harder to conceive.

Research shows that:

• Smoking can reduce fertility, making it difficult to conceive.
• Smoking may negatively affect hormone production.
• Smoking and exposure to tobacco smoke can harm the reproductive system.
• Smoking can damage the DNA in sperm.

If you or someone you love is trying to conceive and uses tobacco, learn more about what it’s like to quit smoking and get started on the path to a smoke-free life.

How Does Smoking During Pregnancy Affect My Baby’s Fetal Development?

Smoking during pregnancy can cause pregnancy complications, negative health effects on the unborn child, miscarriage, and death.

Smoking during pregnancy can put you at a higher risk of pregnancy complications, such as preterm labor and delivery.

Smoking during pregnancy can also result in negative health outcomes for the unborn baby. Every year, approximately 400,000 U.S. infants are exposed to cigarette smoke and its chemicals in the womb. These babies are at risk of a number of complications including:

• Low birth weight.
• Lungs that fail to develop properly.
• Birth defects such as cleft lip and/or cleft palate.
• Sudden Infant Death Syndrome (SIDS).

The chemicals in cigarette smoke may put you at risk for an ectopic pregnancy. Ectopic pregnancy occurs when a fertilized egg fails to reach the womb, but instead begins to grow outside of the womb. This serious condition almost always results in death of the unborn child, and in some cases, death of the mother as well.

Additionally, there is some evidence that smoking during pregnancy may result in miscarriage of the fetus or unborn baby.

No tobacco product is safe to use during pregnancy. Nearly all tobacco products—including most e-cigarettes—contain nicotine, which can cross the placenta and interfere with fetal and postnatal development.

If you’re pregnant and interested in quitting smoking, consult with your health care provider to talk about your reproductive health. You can also get free resources for quitting while pregnant, including a texting program to offer support for pregnant people trying to quit.

Can Smoking Put Me at Risk for Cervical Cancer?

Yes, smoking cigarettes can cause cervical cancer. This type of cancer occurs in the cervix, the lower, narrow end of the uterus that forms a canal between the uterus and vagina.

Within just a few years of quitting smoking, risk of cervical cancer is reduced. If you use tobacco and want to quit, there are resources that can help you quit smoking.

Can Smoking Put Me at Risk for Erectile Dysfunction?

Yes, smoking can increase your risk for erectile dysfunction, a condition in which you are unable to get or keep an erection firm enough for satisfactory sexual intercourse.

Can Smoking Increase My Likelihood of Dying From Prostate Cancer?

Yes, smoking can increase your likelihood of dying from prostate cancer. The prostate is a gland in the male reproductive system and produces a fluid that forms part of the semen. Prostate cancer begins in the prostate.

If you have prostate cancer and smoke, you may be more likely to die from the disease than those with prostate cancer who don’t smoke.

Quitting smoking is one of the most important actions people can take to improve their health. This is true regardless of their age or how long they have been smoking.

Quitting smoking:

• improves health status and enhances quality of life.
• reduces the risk of premature death and can add as much as 10 years to life expectancy.
• reduces the risk for many adverse health effects, including poor reproductive health outcomes, cardiovascular diseases, chronic obstructive pulmonary disease (COPD), and cancer.
• benefits people already diagnosed with coronary heart disease or COPD.
• benefits the health of pregnant women and their fetuses and babies.
• reduces the financial burden that smoking places on people who smoke, healthcare systems, and society.

While quitting earlier in life yields greater health benefits, quitting smoking is beneficial to health at any age. Even people who have smoked for many years or have smoked heavily will benefit from quitting.

Quitting smoking is the single best way to protect family members, coworkers, friends, and others from the health risks associated with breathing secondhand smoke.

Cardiovascular Health Benefits of Quitting Smoking

Quitting smoking is one of the most important actions people who smoke can take to reduce their risk for cardiovascular disease.

Quitting smoking:

• reduces the risk of disease and death from cardiovascular disease.
• reduces markers of inflammation and hypercoagulability.
• leads to rapid improvement in high-density lipoprotein cholesterol (HDL-C) levels.
• reduces the development of subclinical atherosclerosis and slows its progression over time.
• reduces the risk of coronary heart disease with risk falling sharply 1-2 years after cessation and then declining more slowly over the longer term.
• reduces the risk of disease and death from stroke with risk approaching that of never smokers after cessation.
• reduces the risk of abdominal aortic aneurysm, with risk reduction increasing with time since cessation.
• may reduce the risk of atrial fibrillation, sudden cardiac death, heart failure, venous thromboembolism, and peripheral arterial disease (PAD).

People already diagnosed with coronary heart disease also benefit from quitting smoking.

Quitting smoking after a diagnosis of coronary heart disease:

• reduces the risk of premature death.
• reduces the risk of death from heart disease,
• reduces the risk of having a first heart attack or another heart attack.

Respiratory Health Benefits of Quitting Smoking

Quitting smoking is one of the most important actions people who smoke can take to reduce their risk for respiratory diseases.

Quitting smoking:

• reduces the risk of developing COPD.
• among those with COPD, slows the progression of COPD and reduces the loss of lung function over time.
• reduces respiratory symptoms (e.g., cough, sputum production, wheezing).
• reduces respiratory infections (e.g. bronchitis, pneumonia).
• may improve lung function, reduce symptoms, and improve treatment outcomes among persons with asthma.

Cancer-Related Health Benefits of Quitting Smoking

Quitting smoking is one of the most important actions people who smoke can take to reduce their risk for cancer.

Quitting smoking reduces the risk of 12 different cancers, including:

• acute myeloid leukemia (AML)
• bladder
• cancer of the lung
• cervix
• colon and rectum
• esophagus
• kidney
• liver
• mouth and throat (oral cavity and pharynx)
• pancreas
• stomach
• voice box (larynx)

For cancer survivors, quitting smoking may improve prognosis and reduce risk of premature death.

Reproductive Health Benefits of Quitting Smoking

Quitting smoking is one of the most important actions women who smoke can take for a healthy pregnancy and a healthy baby. The best time for women to quit smoking is before they try to get pregnant. But quitting at any time during pregnancy can benefit mother and baby’s health.

Quitting smoking:

• before pregnancy or early in pregnancy reduces the risk for a small-for-gestational-age baby.
• during pregnancy reduces the risk of delivering a low birth weight baby.
• early in pregnancy eliminates the adverse effects of smoking on fetal growth.
• before pregnancy or early in pregnancy may reduce the risk of preterm delivery.

Health Benefits of Quitting Smoking Over Time

Over time, people who quit smoking see many benefits to their health. After you smoke your last cigarette, your body begins a series of positive changes that continue for years.

Reduced risks refer to cessation in comparison to continued smoking.

Each Quit Attempt Is a Step Forward

If you or a loved one are among the 34 million U.S. adults who smoke cigarettes in this country, and want to quit smoking, either for the first time or to make another attempt, do not give up, and know that you are not alone. 

Cigarette smoking remains the leading cause of preventable death and disease in the United States, accounting for 480,000 premature deaths per year. While knowledge of the negative health effects of tobacco use can be helpful on the path to quitting smoking, it’s also important to be aware that many people who smoke do not quit for good on their first attempt and need several tries before they succeed. 

What keeps people smoking even when they know cigarettes are harmful to their health? Nicotine, the highly addictive drug present in tobacco products. Cigarettes are designed to deliver nicotine quickly to the brain and is the main reason that people continue to use tobacco even when they want to quit.

In 2015, nearly 70 percent of current adult smokers in the United States said they wanted to quit.⁴ In 2018, about 55 percent of adult smokers had made a quit attempt in the past year, but only about 8 percent were successful in quitting for 6-12 months.

While it may take several attempts to quit for good, remember that even small successes are wins. For instance, you may find that the next time you try to quit, you are able to go longer without a cigarette than the last time; or you might discover exercise helps to stave off your cravings. Each time you make a quit attempt, you learn new techniques to implement and move one step closer to being able to call yourself a “former smoker.”

The First Couple Days After Quitting

It’s a good idea to talk to your doctor about your quit plan as they may have advice on how to quit smoking that’s best for your situation. However, here’s a couple of things to keep in mind during the first few days after quitting smoking. 

Tobacco Education Resource Library

When you first quit smoking, you may feel some discomfort as the nicotine leaves your system. Having an awareness of the symptoms you could experience will help you to know what to expect and plan for ways you might handle them. After quitting smoking, you may experience temporary depression; disrupted sleep patterns; irritability; anxiety; difficulty concentrating; increased appetite. While uncomfortable, these symptoms should only last a few weeks. 

One other thing to be aware of as you begin your quit journey is that many people who used to smoke find that certain places, occasions, and behaviors—such as drinking coffee, going out with friends, or particularly stressful events—can bring up an urge to smoke even after withdrawal symptoms have ended. Noticing these situations and making a plan to divert your urge to smoke can help you on your way to living a completely smoke-free life.

Quitting is possible. Each quit attempt is not in vain, but rather, can be thought of as practice for quitting for good. With every attempt, you learn more about yourself, including what techniques work for you to help you stave off cravings. Each of these practice tries gets you that much closer to quitting cigarettes forever.

Nicotine Replacement Therapy

When talking with your doctor, they may mention something called nicotine replacement therapy, also referred to as NRT. You may know them better as the FDA-approved therapies such as nicotine skin patches, gum, and lozenges that can help you through the initial part of quitting, by relieving cravings and lessening withdrawal symptoms. 

When you use NRTs, you receive measured amounts of nicotine without the toxic chemicals from cigarette smoke. When used properly, NRTs are safe and effective cessation methods and can double the chances of quitting cigarettes successfully.

Even if you’ve attempted to quit smoking with NRTs before, you may consider trying again because experimenting with different NRT options could help in finding what works for you. NRTs are considered safe enough that multiple methods—for instance the patch and the gum—can be used at the same time. You may start using NRT prior to quitting cigarettes, which could help you avoid some of the initial symptoms that sometimes occur when first quitting. 

NRTs are available both by prescription and over-the-counter for adults age 18 and over, and include:

• Skin patches that deliver nicotine through the skin
• Nicotine gum that releases nicotine as you chew it
• Nicotine lozenges that dissolve in your mouth

Telephone quit line counseling is another effective strategy, and combining counseling with NRTs can be more successful for quitting smoking than nicotine replacement therapy alone.