Smoking tobacco can cause many health problems. Did you know that it can harm your heart and blood vessels?

Smoking is a risk factor for heart disease, which can lead to heart attack, heart failure, and death. About one of every three people in the U.S. dies from heart disease.

Tobacco smoke contains many toxic chemicals. Once those chemicals get inside your body, they travel around in your blood. They can damage your heart and blood vessels. They also affect the cholesterol and fats in your blood.

All this damage can help fats and other debris build up on blood vessels. The blood vessels can become narrower. That prevents blood from flowing through as easily. Not as much oxygen and nutrients can get to the heart. That’s how heart disease develops.

Those narrow blood vessels also raise your blood pressure. That pressure puts stress on your heart.

You can reduce your risk of heart disease by not smoking. Avoiding secondhand smoke also reduces your risk.

Cigarette smoking causes about 1 in every 5 deaths in the United States each year. It's the main preventable cause of death and illness in the United States.

Smoking harms nearly every organ in the body, including the heart, blood vessels, lungs, eyes, mouth, reproductive organs, bones, bladder, and digestive organs.

Learn more about how smoking affects the lungs by reading about COPD (chronic obstructive pulmonary disease) and bronchitis.

Smoking and Your Heart and Blood Vessels

Smoking is a major risk factor for heart disease.

The chemicals you inhale when you smoke cause damage to your heart and blood vessels that makes you more likely to develop atherosclerosis, or plaque buildup in the arteries.

Any amount of smoking, even occasional smoking, can cause this damage to the heart and blood vessels. Smoking poses an even greater risk for some people, especially for women who use birth control pills and people with diabetes.

If you have other heart disease risk factors such as unhealthy blood cholesterol levels, high blood pressure, and overweight or obesity, smoking raises your risk of heart disease even more.

Smoking also increases your risk for peripheral artery disease (PAD). PAD is when plaque builds up in the arteries that carry blood to your head, organs, arms, and legs. People who have PAD have an increased risk for coronary heart disease, heart attack, and stroke.

Secondhand smoke is the smoke breathed out when someone smokes or the smoke that comes from the burning end of a cigarette, cigar, pipe, or other tobacco product. It can damage the heart and blood vessels of people who don’t smoke in the same ways that smoking causes damage to people who do.

Quitting Smoking and Avoiding Secondhand Smoke

One of the best ways to reduce your risk of heart disease is to avoid tobacco smoke.

• Don't ever start smoking.
• If you already smoke, quit. No matter how much or how long you've smoked, quitting will benefit you.
• Avoid secondhand smoke. Don't go to places where smoking is allowed. Ask friends and family members who smoke not to do it in the house and car.

Quitting smoking lowers your risk of getting, and dying from, heart disease. Over time, quitting lowers your risk for atherosclerosis and blood clots too.

If you smoke and already have heart disease, quitting reduces your risk of cardiac death, heart attacks, and death from other chronic diseases.

Not smoking is an important part of a heart-healthy lifestyle, which also includes healthy eating, aiming for a healthy weight, managing stress, and increasing physical activity.

The chemicals in tobacco smoke harm your blood cells. They also can damage how your heart works. These same chemicals may damage how well your blood vessels work and even damage their structure. Tobacco smoke impacts the heart and blood vessels in many ways.

• Contributes to inflammation, which may cause more plaque buildup in your arteries.
• Damages blood vessel walls, making the walls stiff and less stretchy or elastic. That makes the blood vessels narrow.
• Disturbs normal heart rhythms.
• Increases blood pressure and heart rate, making your heart work harder than normal.
• Lowers your HDL (“good”) cholesterol and raises your LDL (“bad”) cholesterol. Smoking also increases your triglyceride level. Triglycerides are a type of fat found in the blood.
• Thickens your blood and makes it harder for your blood to carry oxygen.

The chemicals you breathe in when you smoke damage your heart and blood vessels in ways that increase the chances you will develop atherosclerosis. This increases your risk of having and dying from heart disease, heart failure, or a heart attack long term.

Atherosclerosis is when a waxy substance (plaque) builds up in the arteries. Over time, that plaque hardens and narrows these blood vessels. This limits the flow of oxygen-rich blood to your organs, including your heart, and other parts of your body.

Smoking is a major risk factor for coronary heart disease, a condition that happens when that plaque builds up inside the coronary arteries. These arteries supply your heart muscle with oxygen-rich blood, which it needs to keep working properly.

The buildup of plaque also makes it more likely that blood clots form in your arteries. Blood clots can partially or completely block blood flow.

In short, smoking is a major risk factor for heart disease. Compared with nonsmokers, people who smoke are more likely to get heart disease or have a heart attack.

Smoking’s risks also impact your risk factors in other ways.

• If you already have other risk factors for heart disease, like unhealthy blood cholesterol levels, high blood pressure, and overweight or obesity, smoking makes it much more likely that you will develop it.
• If you already have heart disease, your risk for having a heart attack or dying from one is even higher if you smoke too.
• If you are a woman who uses birth control pills or if you have diabetes, smoking poses a greater risk of heart and blood vessel damage.

Quitting smoking benefits your heart and blood vessels and reduces your risk for heart disease. There are many strategies that aim to help you quit smoking and live a heart-healthy life.

Peripheral artery disease (PAD) is when plaque builds up in the arteries that carry blood to your head, organs, and limbs.

PAD usually affects the arteries that carry blood to your legs. Blocked blood flow from PAD in the arteries of your arms and legs can cause several things to happen.

• You may have cramping, pain, weakness, and numbness in your hips, thighs, and calf muscles if leg arteries are blocked.
• There is an increased risk of infection in a limb affected by a blood blockage, and your body may have a hard time fighting the infection.
• Gangrene, or the death of tissue in the affected area, may also occur. In very serious cases, this can lead to the need to amputate, or remove, the affected limb.

Smoking is a major risk factor for PAD. Even one or two cigarettes smoked in a day can interfere with PAD treatments.

People who smoke and people with diabetes are at highest risk for PAD complications, including gangrene in the leg from decreased blood flow.

Secondhand smoke is the smoke that comes from the burning end of a cigarette, cigar, or pipe. It is also the term for smoke that is breathed out by someone who is smoking.

Secondhand smoke contains many of the same harmful chemicals that people inhale when they smoke. It can damage the heart and blood vessels of people who don’t smoke in the same way that smoking harms people who do.

For adults, secondhand smoke greatly increases your risk of heart attack and death.

For children and teens, secondhand smoke raises the risk of coronary heart disease in the future because over time it:

• Damages heart tissues
• Lowers HDL cholesterol cholesterol
• Raises blood pressure

The risks of secondhand smoke are especially high for premature babies who have respiratory distress syndrome and children who have conditions such as asthma.

One of the best ways to reduce your risk of coronary heart disease is to avoid tobacco smoke.

• Don’t ever start smoking.
• Quit if you already smoke.
• Avoid secondhand smoke. Don’t go to places where smoking is allowed. Ask friends and family members to not smoke in the house and car.

Quitting smoking will help your heart and blood vessels. No matter how much or how long you’ve smoked, quitting benefits you.

• If you already have coronary heart disease, quitting smoking greatly lowers your risk of having more heart attacks or dying from that heart disease. In many studies, quitting smoking has cut this risk of heart attacks or dying by half or even more.
• Your risks of heart disease from smoking get lower soon after you quit. For many people, the risk keeps getting lower over time.
• Your risk of atherosclerosis and blood clots related to smoking gets lowers over time after you quit.

Researchers have studied communities that banned smoking at worksites and in public places. The number of heart attacks in these communities dropped after the bans were in place. These results may be because there were fewer active smokers and people were not exposed to as much secondhand smoke.

There are different strategies that may help you quit smoking. Find your motivation to quit smoking for your heart health, get a support group to help you on your journey, and speak with a healthcare provider if you need medicines to help.

Quitting smoking is possible. It is also hard. There are a few ways to start on the path to quit.

• Quit all at once (also known as going "cold turkey").
• Slowly cut back how much you smoke before quitting completely.
• Talk to your healthcare provider or pharmacist about medicines that may help you quit.

Get Ready to Quit

Try to get motivated when you decide you are ready to quit.

• Make a list of your reasons for wanting to quit.
• Write a contract to yourself that outlines your plan for quitting.
• If you've tried to quit smoking in the past, think about those tries. What helped? What made it harder?
• Know what triggers you to smoke. Do you smoke after a meal, while driving, or when you're stressed? Make a plan to handle each trigger.

Get Support

• Set a quit date and let those close to you know about it.
• Ask your family and friends to support you.
• Consider getting support from 1–800–QUIT–NOW or smokefree.gov. These resources can help you set up a plan to quit.

Get Medicine and Use It Correctly

Talk with your healthcare provider and pharmacist about products that can help you quit smoking. These medicines and products are helpful for many people.

• You can buy nicotine gum, patches, and lozenges from a drug store.
• Other medicines to help you quit smoking can be prescribed by your provider.

Learn New Skills and Behaviors

Try new activities to replace smoking.

• Instead of smoking after a meal, take a brisk walk in your neighborhood or around your office building.
• Take up knitting, carpentry, or other hobbies and activities that keep your hands busy.
• Avoid other people who smoke. Ask those you can't avoid to respect your effort to stop smoking and not smoke around you.
• Remove cigarettes, ashtrays, and lighters from your home, office, and car.
• Don't smoke at all—not even one puff.
• Try to avoid alcohol and caffeine. People who drink alcohol are more likely to start smoking again after quitting.
• You can help control your weight gain from quitting smoking, which is on average 10 pounds or less, by following a heart-healthy lifestyle and being physically active.

Each step you take to remove smoking from your life improves the health of your heart and blood vessels. Remember to celebrate the small wins you achieve as you work toward becoming smoke free.

Be Prepared for Withdrawal and Relapse

Be prepared for the challenge of withdrawal. It helps to know that withdrawal symptoms get better after only 1 or 2 weeks of not smoking and each urge to smoke lasts only a few minutes.

You can take steps to cope with withdrawal symptoms.

• If you feel like smoking, wait a few minutes for the urge to pass.
• Remind yourself of the benefits of quitting.
• Don't get overwhelmed—take tasks one step at a time.

If you relapse, or smoke after you've quit, try not to get discouraged and give up. Instead try some of the steps below.

• Ask yourself what caused you to do it. Were you stressed out or unprepared for a situation that you associate with smoking? Make a plan to avoid or handle this situation in the future.
• Try to accept that you smoked, learn from it, and recommit to your plan to quit. Getting frustrated with yourself only makes it harder to commit to quit again.
• Even if you start smoking regularly again, don't give up. Most people who smoke need a few tries to quit before finally being successful.
• Think about what you need to do to get back on track to meet your quitting goal.
• Set a new quit date.
• Ask your family and friends to help you stay on track.
• Talk to your healthcare provider about other resources to help you quit.

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.