Smoking (patient information)

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Editor-in-Chief: Meagan E. Doherty

Smoking Risks

  • Smoking increases the chance of heart disease. Several ingredients of tobacco lead to the narrowing of blood vessels, increasing the likelihood of a blockage, and thus a heart attack or stroke. According to a study by an international team of researchers, people under 40 are five times more likely to have a heart attack if they smoke.[1]
  • Smoking doubles your risk of having a heart attack when smoking a pack a day or more when compared with nonsmokers.[2]
  • A team of British scientists headed by Richard Doll carried out a longitudinal study of 34,439 medical specialists from 1951 to 2001, generally called the "British doctors study."[3] The study demonstrated that smoking decreased life expectancy by 10 years and that almost half of the smokers died from diseases possibly caused by smoking (cancer, heart disease, and stroke). About 5,900 of the study participants are still alive and only 134 of them still smoke.
  • Regular smokers are estimated to live to 2.5[4] to 10[5] years less than nonsmokers.[4]

The Risks of Second Hand Smoke

  • People exposed to second hand smoke increase their risk of heart disease 25-30%
  • Exposure to second hand smoke increases your risk of developing lung disease, heart disease and certain types of cancer.
  • Second hand smoke causes approximately 3,000 lung cancer deaths each year in nonsmokers.
  • Approximately 46,000 nonsmokers who live with smokers and are exposed to second hand smoke on a regular basis die each year from heart disease.
  • Even small doses of second hand smoke exposure pose an increased risk for heart disease. According to a Report of the Surgeon General in 2006 short term exposures to second hand smoke increase the stickiness of blood platelets, which increases the risk of myocardial infarction by damaging the lining of blood vessels and decreases blood flow through the coronary arteries.[6]

How Quitting Impacts your Risk of Disease

Quitting smoking is extremely beneficial to your health and can, after time, even reverse some of the negative side effects that smoking has on your health:

  • Abstaining from cigarettes for 1 year cuts your risk of heart attack in half when being compared to a currently active smoker.[7]
  • 5-15 years after quitting, your risk of having a stroke is comparable to that of and individual that never smoked. Around the 10 year mark your risk of developing lung cancer also decreases to that of a nonsmoker.[8]
  • 15 years after quitting, your risk of heart disease is comparable to someone who has never smoked.[9]

Benefits of Smoking Bans: Communities That Don't Smoke

There is evidence that smoking bans instituted in certain cities have shown significant health effects in the general population:

  • In the first 18 months after the town of Pueblo, Colorado enacted a smoking ban in 2003, hospital admissions for heart attacks dropped 27%. Admissions in neighboring towns without smoking bans showed no change.[10]
  • A 2007 study of the effect of the ban in Scotland showed that there was 17% year-on-year drop in heart attack admissions since the ban was introduced in March 2006.[11] An analysis of the saliva of 39 non-smoking workers before and after the Scottish smoking ban came into force found a 75% fall in cotinine, which is a by-product of nicotine. The level of cotinine is a good indicator of how much cigarette smoke has entered the body.[12]

Smoking Cessation Success Rates

Percent increase of success for six months over unaided attempts for each type of quitting (chart from West & Shiffman based on Cochrane review data)[13]
  • About 10% of people who quit unaided will remain non-smokers for 12 months.[14]
  • The American Cancer Society states,"that between about 25% and 33% of smokers who use medicines can stay smoke-free for over 6 months"[15]
  • Experts screened over 8700 research articles published between 1975 and 2007. More than 300 studies passed the criteria for the gold standard trials. Using these 300 studies for a meta-analysis of relevant treatments, it gives advice on smoking cessation treatment. An additional 600 reports were not included in the meta-analysis, but helped formulate the recommendations.

In general:

a) Control groups quit at a rate of around 10%.
b) Pharmacological treatments resulted in 15-33% quit rates.
d) Psychosocial interventions resulted in 14-25% quit rates.
e) Little or no evidence was found to support use of hypnosis, acupuncture, or laser therapy as treatments for smoking cessation, alternate medicine or cigarette substitutes.


  1. "Health : Young smokers' heart attack risk". BBC. Retrieved 2005-12-18.
  2. [1] Smoking and Heart Disease
  3. Richard Doll, Richard Peto, Jillian Boreham, Isabelle Sutherland (2004). "Mortality in relation to smoking: 50 years' observations on male British doctors". BMJ. 328 (1519): 1519. Unknown parameter |month= ignored (help)
  4. 4.0 4.1 Ferrucci L, Izmirlian G, Leveille S; et al. (1999). "Smoking, physical activity, and active life expectancy". Am. J. Epidemiol. 149 (7): 645–53. PMID 10192312.
  5. Doll R, Peto R, Boreham J, Sutherland I (2004). "Mortality in relation to smoking: 50 years' observations on male British doctors". BMJ. 328 (7455): 1519. doi:10.1136/bmj.38142.554479.AE. PMID 15213107.
  6. [2] American Heart Association
  7. [3] Heart and Vascular Health & Prevention
  8. [4] Heart and Vascular Health & Prevention
  9. [5] Heart and Vascular Health & Prevention
  10. Heart attacks decline after smoking bans American Heart Association
  11. Scots smoke ban 'improved health'
  12. Ban 'boost for non-smoking staff'
  13. West & Shiffman, p. 59
  14. Sutherland, Gay (May 16, 2005). "Methods for quitting". NetDoctor. Retrieved May 22, 2010.
  15. "Guide to Quitting Smoking". The American Cancer Society. Retrieved May 27, 2010.

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