How does smoking relate to cardiovasucular disease?

Smoking affects your health in a big way. The many harmful chemicals in cigarettes cause damage to nearly every organ in your body, including your heart, blood vessels, mouth, eyes, lungs, bones, reproductive organs, bladder, and digestive organs. This is why smoking causes so many deaths — more than 37,000 Canadians will die prematurely each year from tobacco use and almost 6,300 non-smokers will die from exposure to second-hand smoke.

Any amount of smoking — light, occasional, or second-hand — is dangerous and likely to cause damage to your cardiovascular system. The harmful chemicals from a cigarette can negatively affect the condition and functioning of your heart and blood vessels. For example, nicotine increases your heart rate, while carbon monoxide (a toxic gas) replaces oxygen in your red blood cells. Together, these affect the normal function of your heart, eventually making it work harder. Over time, smoking also causes plaque to build up in your arteries, a decrease in the oxygen in your blood, and increased blood pressure.14 What you face as a smoker if you continue to smoke includes the following:

  • On average, smokers live 10 fewer years than non-smokers.
  • Smokers have double the risk for cardiovascular disease compared to non-smokers.
  • Smokers are up to four times more likely to experience sudden cardiac death in comparison to non-smokers.
  • Smoking causes about 10 per cent of cardiovascular disease overall, and it’s especially dangerous for women. Being a smoker puts younger women at 60 per cent higher risk for heart disease than men of the same age, effectively cancelling out the protection most young women seem to have from heart disease.
  • In a long-term study of 12,000 women, even smoking just one to four cigarettes a day doubled the risk of dying from a heart attack significantly.

Smoking also:

  • Raises your LDL (lousy) cholesterol
  • Lowers your HDL (healthy) cholesterol
  • Speeds up your heart rate
  • Raises your blood pressure
  • Makes your heart work harder

Risks to your health

Smoking is associated with many health risks for both the smoker and those exposed to the second-hand smoke, causing significant damage to the entire body. Although no level of smoking is considered safe, smoking fewer cigarettes for a shorter period of time can reduce the damage. Any level of smoking can cause the following:

Short-term risks:

  • Shortness of breath
  • Worsening of asthma symptoms
  • Respiratory infection
  • Harm to pregnancy
  • Infertility
  • Impotence

Long-term risks:

  • Lung cancer
  • Cancers of the colon, mouth, throat, bladder, and cervix
  • Emphysema and bronchitis
  • Smoker’s cough
  • Heart disease and stroke
  • Complications during pregnancy that can lead to an underweight baby or premature death in infancy
  • Osteoporosis
  • Digestive problems
  • Compromised immune system — increased likelihood of flu and pneumonia
  • Decreased vitamin C levels, causing wounds to heal more slowly
  • Restricted circulation in the legs
  • Macular degeneration (vision loss at the centre of the field of vision)
  • Psoriasis
  • Gum disease
  • Tooth loss
  • Raynaud’s phenomenon (fingers that turn white or blue in the cold)6 7

Second hand smoke

Second-hand smoke is the smoke from a tobacco product exhaled into the environment. It contains not only asbestos, arsenic, ammonia, and benzene but more carbon monoxide and tar than the smoke that is inhaled by the smoker. Because the harmful chemicals remain in the air long after the cigarette is smoked, non-smokers frequently in contact with second-hand smoke experience excessive coughing and are at risk of developing heart disease, lung cancer, emphysema, and chest infections — putting them at increased risk for premature death.

The smoke exhaled by the smoker tends to be more toxic than the smoke burning directly from the end of the cigarette. Therefore, those exposed to second-hand smoke are essentially inhaling the same chemicals as the smoker but with an increased sensitivity that comes with being a non-smoker.

Smoking is not a habit, it's an addition

Quitting smoking is hard, but it’s not impossible. Every year, thousands of people go smoke-free. Quitting smoking is the most powerful thing you can do to reduce your risk for heart disease. Because smoking is so highly addictive, quitting is extremely difficult and requires persistent effort and help from others.

The decision to quit smoking is influenced by your beliefs about the benefits of quitting and by the physical dependence of smoking. Many smokers attempt to quit several times before succeeding. When you are ready to quit, a variety of proven methods are available to increase your chances.

Your quit plan should include a range of strategies to address the various aspects of smoking. Smoking is an addictive process that becomes a learned behaviour, and it is supported in three ways:

  1. Physical Dependence 
    Nicotine is a powerfully addictive drug. Once inhaled through cigarette smoke, nicotine is rapidly absorbed into your bloodstream. Your body quickly learns to crave its presence. When you stop smoking, the amount of nicotine in your body drops and you may experience irritability, difficulty sleeping, changes in appetite, and fatigue. Reactions vary from person to person. These are normal signs of recovery from nicotine.

  2. Behavioural Conditioning 
    Smoking behaviours are repetitive and, over time, can become unconscious habits reinforced by where you smoke, the activities you engage in while smoking, and the emotions you feel when you have a cigarette. Behaviours that are repeated hundreds of thousands of times each year add to the difficulty of quitting.

  3. Social Aspects 
    Many people smoke in the company of friends and family. The social aspects of nicotine dependence are difficult to overcome. This is because once you quit, you are still exposed to the social situations that remind you of smoking. Nevertheless, you can learn to handle social situations so that they are not triggers for smoking.

How Can I Stop Smoking?

Quitting smoking is the most important thing you can do to positively affect your heart health. Becoming smoke-free at any age improves your health and can extend your life. It’s never too late to quit, but the sooner you quit, the sooner your body can begin to heal and repair the damage caused by smoking. The following are just a few of the many positive statistics associated with quitting the habit:

  • The benefits of quitting begin within 20 minutes of your last cigarette, and at one year, your risk for a heart attack is reduced by 50%.
  • Within just 24-hours of quitting, your blood pressure and pulse rate may drop. 
  • Fifteen years after you quit, you are at no greater risk for death than a non-smoker.
  • Quitting smoking lowers your risk for hospitalization and death.
  • More than 6.6 million Canadians have successfully kicked the habit.3
  • Smoking is the most preventable cause of cardiovascular disease.
  • No matter how long you have smoked, quitting will greatly improve your health.

Because smoking is so highly addictive, quitting is extremely difficult. On average, most smokers try to quit five to seven times before finally succeeding.5

Success requires making a continual effort and getting plenty of help through a combination of counselling and medications that specifically target quitting. Putting in the effort can return your health to that of a non-smoker within a few years, offering you a longer, healthier life.

What To Expect When You Quit

Knowing what to expect when you quit smoking can reduce stress and give you a better chance at success.

You’ll notice your body undergoing big changes as soon as you quit. Here’s a guide to some of what you might experience along with tips for adapting your behaviour so you can ride out any possible early discomfort.

Withdrawal Symptoms: It’s normal to experience withdrawal symptoms when quitting smoking. Symptoms may include headache, dizziness, mild confusion, anxiety or restlessness, difficulty concentrating, and changes in your mood. Medication that aids in quitting will help reduce or eliminate these withdrawal symptoms. Withdrawal symptoms typically begin on the first day of quitting and dissipate around the fourth week.

As your body gets less nicotine, you will feel more and more uncomfortable. This discomfort will peak after two to three days, signaling that your body is beginning to heal from the damage of smoking. Over time, your brain will adapt to the reduced nicotine and many of your withdrawal symptoms will subside. Keep in mind that your discomfort is only temporary. The benefits of quitting last a lifetime.

Cravings: Cravings are common. Their intensity usually decreases over two to three weeks. Remember that a craving normally last only three to five minutes. Try to keep yourself occupied for that time and the craving should pass. The good news is that each new day without a cigarette will be easier and your cravings and withdrawal symptoms will decrease.

Dealing With Stress: Stress is a normal part of life. Many people smoke because they believe it helps them cope with stress. Actually, smoking can increase stress because nicotine causes your heart rate and blood pressure to rise. You may want to join a support group or find a friend to quit with or talk to. Learn to relax, and when you feel stress coming on, take deep breaths through your nose.

Changes to Your Mood: As your body adapts to being a non-smoker, you may feel anxious, irritable, depressed, or have difficulty concentrating. Be patient with yourself in the first few weeks after quitting. If you’re taking a quitting aid and your family notices that you are agitated, in a depressed mood, or that your behaviour is changing in unusual ways, stop taking the medication and contact your follow-up support or family doctor immediately. Do the same if you have an allergic reaction.

Coughing: Many smokers find that they cough more in the first few weeks after quitting. This means your lungs are clearing. Consider it a sign that you are getting healthier.

Managing Body Weight: Experiencing an increase in appetite is normal while quitting smoking. Some people can gain 5 to 7 pounds during the first few months of quitting. Making a small change to your diet (choosing healthy snacks and drinking plenty of water) and exercise routine (going for a 30 minute walk) can help manage your appetite and keep your weight in check.

Effects of Caffeine: Cut back your intake of caffeine by at least half, either by reducing the number of cups of coffee, tea, or colas that you drink each day or by switching to decaffeinated beverages. Non-smokers are more affected by caffeine and reducing your intake will help you avoid any unpleasant effects, such as “caffeine jitters,” nervousness, irritability, headaches, sleeplessness, or heart palpitations.

Quitting Process

Start by making your own plan for quitting, including creating a support network and getting professional advice before you begin. Preparing a roadmap for quitting will help you overcome obstacles and cravings as they pop up.

Remember: Most people find that the more support they get while trying to quit, the better! Knowing what’s ahead as you stop smoking can help you develop ways to overcome the challenges. It helps to think of quitting as following roughly five stages:

  • Stage 1 — Not Yet Ready

At this stage, you may have no intention of quitting. But you can do some research and seek nonjudgmental support. Part of this early process involves understanding why you smoke, how it affects your health, and what you can expect when you finally quit.

  • Stage 2 — Considering the Quit Process

You’re beginning to identify your concerns about quitting and plan strategies to overcome the challenges of giving up cigarettes. By thinking about solution ahead of time, you can strengthen your resolve to quit.

  • Stage 3 — Preparing to Quit

This is the stage at which you begin to understand your reasons for smoking and to pinpoint the combination of quit methods that will work best for you throughout the process. In addition, you should select a quit date and develop coping strategies to help you succeed.

  • Stage 4 — Quitting Smoking

You create a specific plan that will carry you through the quit process. A range of coping strategies (medications, behavioural and social reconditioning) will help you tackle the nicotine withdrawal that’s at the centre of smoking addiction.

  • Stage 5 — Remaining Smoke-Free

The challenge continues as you incorporate strategies to remain smoke-free. Throughout the quit process, seek support and advice to help you change your behaviour, control your surroundings, reduce stress and recover from the inevitable slip-ups.


There are many proven techniques to help you quit smoking. Medication is one of them.

It’s true that these medications come with a price tag, but consider this: The cost of smoking one pack of cigarettes is about $14 per day, $70 per week, or $3,920 per year. Think of the money you will save over the long term once you quit!

Recognizing Your Smoking Triggers

Smokers tend to develop a set of conditioned responses to smoking. These are often referred to as “triggers” because they reinforce the habit of smoking and strengthen the addiction. Before attempting to quit, it’s important that you learn to recognize your own smoking triggers and then find strategies to avoid them. Pinpoint your triggers in advance of your quit date by taking note of the following:

  • The times of day in which you smoke
  • What you’re feeling when you light up
  • The strength of your desire to smoke (mild, medium, strong, intense)
  • Where you are and what you’re doing when you smoke
  • Who is with you when you smoke

Once you recognize your triggers, appropriate coping strategies can be used to aid in changing your behaviours. Identify your own personal triggers to devise effective coping strategies and avoid tempting situations.

Relapse Prevention

It’s normal to relapse. Before it happens, make sure you have a plan for getting back on track.

If you find yourself smoking, do the following:

  • Change Your Situation

Stop smoking immediately, leave the room, throw out your cigarettes and carry on with your quit attempt.

  • Talk Positively to Yourself

Remind yourself how far you have come and encourage yourself to keep at it.

  • Take Action

Find something else to do that makes it difficult to smoke, such as showering, engaging in physical activity, or chewing gum.

  • Ask for Help

Talk to someone to distract or encourage you.

Don’t let a slip throw you off your plan.

Any amount of smoking — light, occasional, or second-hand — is dangerous and likely to cause damage to your cardiovascular system and many other parts of your body. More than 37,000 Canadians will die prematurely each year from tobacco use and almost 6,300 non-smokers will die from exposure to second-hand smoke.

But no matter how long you have smoked, quitting will greatly improve your health. Take advantage of the resources in our community and online to get advice and support — and get started. The University of Ottawa Heart Institute’s Quit Smoking Program is available to all smokers who are interested in quitting. We use proven techniques and individualized counselling to help people kick the habit. To register for the Quit Smoking Program, please call  613-696-7069 or visit our website.