Effects of Smoking

About 350,000 deaths each year are directly or indirectly caused by smoking. One out of two smokers die prematurely because of their cigarette smoking. Smoking is more deadly than all other risk factors for heart disease combined-the risk of heart disease is eight times higher in smokers than in nonsmokers. Smoking also redistributes body fat, increasing the gap between waist and hip measurements. This pattern of fat is linked with risk factors that increase the chance of heart disease, diabetes, and early death. Aging is the most important risk factor for the development of heart disease-and cigarette smoking ages a person faster than the calendar.

Chemical Effects. Thousands of chemicals in cigarette smoke affect the heart, circulation, and other body organs. Smoking introduces carbon monoxide into the lungs, which reduces the amount of oxygen available to the heart muscle and the rest of the body. Nicotine, an addictive drug, causes the heart to beat faster and constricts blood vessels. It may also cause lung problems, which in turn make the heart work harder. Some smokers hope that reduced tar and nicotine cigarettes will decrease the harmful effects of these chemicals and will reduce the risk of heart attack. However, most people who use these brands tend to smoke more cigarettes each day and to inhale more deeply, thus maintaining the higher level of nicotine the body craves.

Atherosclerosis. Atherosclerosis, also called hardening of the arteries, is caused by deposits of fat, cholesterol, and other substances that build up on the inner wall of the artery, creating plaque. Over time, the inside diameter of the artery becomes smaller, and blood flow through the artery is reduced or stopped. Blocked arteries cannot supply an adequate amount of oxygen-rich blood to the organs, muscles, and tissues. Blood clots also form more easily in atherosclerotic vessels; they can lodge in a narrowed artery and block the flow of blood.

The risk of developing atherosclerosis is greater in people who smoke. Fat builds up more easily on arterial walls damaged by the carbon monoxide in cigarette smoke, and total cholesterol levels in the blood increase half a point for each cigarette smoked.

Smoking makes the blood thicker, so it is harder for the heart to pump. Slow-moving blood is more likely to clot and block a narrowed artery.

Atherosclerosis is a leading cause of heart attack and stroke. Coronary artery disease (which includes atherosclerosis) is the leading cause of death in the United States.

Heart Attack and Stroke. Smokers have 70% more heart attacks and a higher number of strokes than nonsmokers. The risk of having a heart attack or stroke is directly related to the number of cigarettes a person smokes each day: the more cigarettes smoked, the greater the risk. Continuing to smoke after a heart attack increases the chance of having a second attack.

Smoking increases the release of hormones (epinephrine and norepinephrine) into the bloodstream. This may cause severe spasm in the coronary arteries or irregular heartbeats, perhaps resulting in a fatal heart attack.

Blood pressure increases when a cigarette is smoked. Long-term smoking may contribute to hypertension (consistently high blood pressure), the major risk factor for all forms of stroke.

Angina. Angina is the chest pain that occurs when the heart muscle does not receive enough oxygen. Because smoking reduces the amount of oxygen in the blood and makes the heart beat faster, the heart requires more oxygen. Thus, chest pains occur more easily in patients with angina who smoke.

Peripheral Vascular Disease. Narrowing of the blood vessels in the arms and legs may eventually result in damage to or loss of a limb. This condition is more likely to occur in smokers, as are the clots that can block the narrowed vessels. Diabetes is another important risk factor for peripheral vascular disease, placing diabetics who smoke at significantly higher risk.

Respiratory Diseases. Smoking is the single most important cause of chronic respiratory disorders and lung cancer. Chronic obstructive pulmonary disease (COPD) affects nearly 10 million Americans, with 80% of cases due to smoking. COPD is the fifth leading cause of death in the United States.

Drug Interactions. Cigarette smoking may interfere with the normal metabolism of medication. Tar and nicotine can cause the liver to process and rid the body of some drugs faster than intended, so the full effect of the medication is not received. The effects of the thousands of chemicals in the cigarette smoke, many of them toxic, have still not been studied in detail.

Smokers who take birth control pills have a 39% higher rate of heart attacks.

Ulcers. Peptic ulcer disease is aggravated by smoking. About 5 to 10% of Americans have ulcers at some time, costing over $4 billion each year.

Sex. Smoking may increase the incidence of impotency.

Wrinkles. Smokers develop more facial wrinkles, especially around the mouth and eyes and on the neck. Blood does not circulate as well to all the tissues when a person smokes, so the skin does not receive the oxygen and nutrients it needs for good health.

Passive Smoking

Second hand smoke - the cigarette smoke floating freely in the air from another person's cigarette - is harmful for nonsmokers. Passive smoke may increase the risk of lung, cervical, and breast cancer; heart disease; emphysema and bronchitis; and stroke. (In fact, dogs whose owners smoke have a 50% higher rate of lung cancer!) Consequently, nearly all states have passed laws that regulate smoking in public places, including restaurants, offices, and airplanes.

Smoking and Children

Women who smoke while they are pregnant harm their unborn babies. Smoking during the first three months of pregnancy may cause the baby to have a cleft lip or palate or abnormal heart formation. Smoking during the last six months of pregnancy may cause the baby to grow more slowly, weigh less at birth, and have neurological and developmental problems. Fetal and newborn death rates are also higher among babies whose mothers smoke.

Nicotine is found in breast milk, so breast-feeding passes this addictive drug to the baby. Smoking moms also cause their breast-fed babies to have more colic-40% versus 26% of nonsmokers' babies.

Children whose parents smoke are about twice as likely to have health problems than other children, especially bronchitis and pneumonia. They also do not score as well on intelligence tests as children whose parents do not smoke.

Though the number of adult smokers has been dropping, the number of teenage girls who begin smoking is increasing. Some children start smoking as early as fourth grade. Adolescents face special problems in avoiding the smoking habit.

Peer pressure is a tremendous force among the young. Those who smoke only occasionally may be helped by learning how to resist peer pressure. Teenagers who smoke daily and have become addicted to nicotine need another kind of help to overcome the habit. Parental example also encourages children to smoke or not: when one or both parents smoke, the child is more likely to become a smoker.

A study by the American Health Foundation shows that people who began smoking at an early age smoke more heavily as adults. Those who pick up the habit earliest in life have the greatest risk of heart attack.

Benefits of Quitting Smoking

Smoking is the most easily preventable risk factor for heart disease. The chance of dying from a heart attack begins to drop within 30 minutes of quitting smoking. As nicotine leaves the cardiovascular system, the pulse slows, blood pressure returns to normal, and coronary artery spasms disappear. Red blood cells carrying carbon monoxide are completely replaced by oxygen-carrying cells within four months. Once a person has quit smoking, the risk of having a heart attack is greatly decreased within six months. The severity of peripheral vascular disease is also reduced.

Nagging smoker's cough, shortness of breath, and decreased physical ability all improve after a person quits smoking. Other advantages include improved appearance (especially changes in the skin) and elimination of smoker's breath and odors clinging to hair, clothes, and furniture.

Weight Gain

Some smokers are reluctant to quit because they believe they will gain weight. While they are often concerned about their appearance, some claim that because obesity is a risk factor for cardiovascular disease, gaining weight will endanger their health.

In fact, the obvious health benefits of quitting smoking clearly outweigh the fact that a few pounds may be gained. Gaining even fairly large amounts of weight is not as hazardous as smoking. Smoking is a deadly method of weight control.

A study by the Centers for Chronic Disease Prevention and Health Promotion showed that, on average, men gained about six pounds and women gained about eight pounds after they quit smoking.

Those who tended to gain the most were younger patients, African Americans, and people who were not heavy smokers. People who smoked more than 15 cigarettes per day were generally overweight even before they stopped smoking. Overall, the study showed that smokers tend to weigh less than their nonsmoking counterparts, but when they stop smoking, their weight gain is minimal, usually bringing them up to their ideal weight.

Most patients who quit smoking can expect to gain only a small amount, perhaps four to six pounds. About half will gain less.

How to Quit Smoking

The desire to quit smoking is the most important step in conquering this habit. It is not an easy habit to break, and many smokers make several attempts before they are able to quit successfully. Only about 25% are able to quit on the first try.

Successful quitters also depend on social support. Receiving encouragement from a friend or family member is a great help.

A number of group support programs are available to help people stop smoking, including those offered through the American Heart Association and the American Lung Association. Most smokers-about 90%-are eventually able to quit on their own, but many are helped by formal programs that teach behavior modification techniques and provide moral support during the difficult early days.

Nicotine gum and nicotine patches placed on the skin help relieve the withdrawal symptoms heavy smokers experience. The combination of a nicotine patch or gum and a group support program is often the best solution for smokers who are very dependent on nicotine.

If you smoke and have heart disease, by all means, quit now. Your increased risk of heart disease - including heart attack and blocked arteries to your legs - is not going to get better if you continue to smoke, and it is certainly not going to get worse if you stop smoking and gain a few pounds. Quitting smoking is one of the biggest favors you can do for yourself, your family, your pets, and your heart.

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