Smoking and Heart Disease and Stroke

What Are Heart Disease and Stroke?

Heart disease and stroke are cardiovascular (heart and blood vessel) diseases (CVDs).1

Heart disease includes several types of heart conditions. The most common type in the United States is coronary heart disease (also known as coronary artery disease). Coronary heart disease occurs when the walls of arteries that carry blood to the heart are narrowed by plaque, a process known as atherosclerosis.2,3 This can cause:

  • Chest pain2
  • Heart attack (when blood flow to the heart becomes blocked and a section of the heart muscle is damaged or dies)2,4
  • Heart failure (when the heart cannot pump enough blood and oxygen to support other organs)2,5
  • Arrhythmia (when the heart beats too fast, too slow, or irregularly)2,6

A stroke occurs when the blood supply to the brain is blocked or when a blood vessel in the brain bursts, causing parts of the brain to become damaged or die.7 Stroke can cause disability (such as paralysis, muscle weakness, trouble speaking, or memory loss)7 or death.

How Is Smoking Related to Heart Disease and Stroke?

Smoking is a major cause of cardiovascular disease (CVD) and causes one of every four deaths from CVD.9 Smoking can:10

  • Raise triglycerides (a type of fat in your blood)
  • Lower “good” cholesterol (HDL)
  • Make blood sticky and more likely to clot, which can block blood flow to the heart and brain
  • Damage cells that line the blood vessels
  • Increase the buildup of plaque (fat, cholesterol, calcium, and other substances) in blood vessels
  • Cause thickening and narrowing of blood vessels
How Is Breathing Secondhand Smoke Related to Heart Disease and Stroke?

Breathing secondhand smoke also harms your health. Secondhand smoke is the smoke from burning tobacco products.9,11,12 Secondhand smoke also is smoke breathed out by a someone smoking.11,12

Breathing secondhand smoke can cause coronary heart disease and stroke.10,11,12 Know the facts:9

  • Secondhand smoke causes nearly 34,000 early deaths from coronary heart disease each year in the United States among nonsmokers.
  • Nonsmokers who breathe secondhand smoke at home or at work increase their risk of developing heart disease by 25–30%. Secondhand smoke increases the risk for stroke by 20−30%.
  • Each year, secondhand smoke exposure causes more than 8,000 deaths from stroke.
  • Breathing secondhand smoke interferes with the normal functioning of the heart, blood, and vascular systems in ways that increase your risk of having a heart attack.
  • Even briefly breathing secondhand smoke can damage the lining of blood vessels and cause your blood to become stickier. These changes can lead to a heart attack.
How Can Heart Disease and Stroke Be Prevented?

Heart disease and stroke are major causes of death and disability in the United States. Many people are at high risk for these diseases and don’t know it. The good news is that many risk factors for heart disease and stroke can be prevented or controlled.

The federal government’s Million Hearts® initiative aims to prevent 1 million heart attacks and strokes within five years. It’s important to know your risk for heart disease and stroke and to take action to reduce that risk. A good place to start is with the ABCS of heart health:14

  • Aspirin: Aspirin may help reduce your risk for heart disease and stroke. But do not take aspirin if you think you are having a stroke. It can make some types of stroke worse. Before taking aspirin, talk to your doctor about whether aspirin is right for you.
  • Blood pressure: Control your blood pressure.
  • Cholesterol: Manage your cholesterol.
  • Smoking: Quit smoking, or don’t start.

In addition to your ABCS, several lifestyle choices can help protect your heart and brain health. These include the following:13,14

  • Avoid breathing secondhand smoke.
  • Eat fresh fruits and vegetables.
  • Eat low-fat, low-salt foods most of the time.
  • Maintain a healthy weight.
  • Exercise regularly.
  • Limit alcohol use.
  • Control other health conditions (such as diabetes).
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Tonya

Tonya M. was diagnosed with heart failure when she was 38. While on the list for a heart transplant, Tonya’s condition worsened. In 2013, she had a battery-operated heart pump inserted in her chest to help blood circulate through her body. Tonya died in 2022 at the age of 53.

“I wish I had quit sooner. I wish I had never picked up a cigarette.”


Real stories about heart disease and stroke:

Today I start my quit journey. Free resources provided by smokefree.gov
Additional Resources

Tonya M., a participant in the Tips From Former Smokers® (Tips®) campaign, smoked cigarettes for more than 23 years and was diagnosed with heart failure when she was 38. Tonya eventually had a left ventricular assist device (LVAD) surgically inserted inside her chest. The LVAD is a battery-operated mechanical pump that helps her weakened heart continuously move blood through her body. For more information about LVADs, visit the American Heart Association’s website.

Brian H., another Tips campaign participant, smoked heavily and had a heart attack at age 35. He learned how important it was to quit—and to stay quit. By doing so, he eventually qualified for and received a precious gift—a heart transplant. For more information about organ donation, go to organdonor.gov.

  1. U.S. Department of Health and Human Services. A Report of the Surgeon General. The Health Consequences of Smoking. [PDF – 300 KB] Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2004 [accessed 2022 Feb 7].
  2. Centers for Disease Control and Prevention. About Heart Disease [last reviewed 2021 September 27; accessed 2022 Feb 7].
  3. U.S. National Library of Medicine. Coronary Heart Disease [updated 2022 Feb 4; accessed 2022 Feb 7].
  4. Centers for Disease Control and Prevention. Heart Attack [last updated 2021 January 11; accessed 2022 Feb 7].
  5. Centers for Disease Control and Prevention. Heart Failure Fact Sheet [last reviewed 2020 September 8; accessed 2022 Feb 7].
  6. National Heart, Lung, and Blood Institute. What is an Arrhythmia? [accessed 2022 Feb 7].
  7. Centers for Disease Control and Prevention. About Stroke [last reviewed 2021 August 2; accessed 2022 Feb 7].
  8. Centers for Disease Control and Prevention. Types of Stroke [last reviewed 2021 August 2; accessed 2022 Feb 7].
  9. U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2014 [accessed 2022 Feb 7].
  10. U.S. Department of Health and Human Services. A Report of the Surgeon General. How Tobacco Smoke Causes Disease: What It Means to You. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2010 [accessed 2022 Feb 7].
  11. Institute of Medicine. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the Evidence. Washington: National Academy of Sciences, Institute of Medicine, 2009 [accessed 2022 Feb 7].
  12. National Toxicology Program. Report on Carcinogens, Fifteenth Edition. Research Triangle Park (NC): U.S. Department of Health and Human Services, Public Health Service, 2021 [accessed 2022 Feb 7].
  13. U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2006 [accessed 2022 Feb 7].
  14. U.S. Department of Health and Human Services. Million Hearts® [last reviewed: 2022 January 20; accessed 2022 Feb 7].