Cigarette smoking is probably the most potent single lifestyle factor contributing to risk of coronary artery disease (CAD) in the populations of Western and developing nations.
With the advent of anti-smoking laws and a general social prohibition on smoking in the West, the tobacco companies have been targeting developing countries. As a result, young people and women in these countries are smoking far more than previously. This increases the potential for CAD in these populations.
The risk of CAD is increased at least two-fold in the general population who smoke and considerably more in those with other risk factors as well. For example, if you are diabetic, obese and smoke, then your risk of CAD is even higher than that of a smoker without these factors.
Cigarettes act directly on the walls of the arteries to promote:
aggregation of lipids in artery walls
injury of the inner lining of the artery which contributes further to the aggregation of lipids
activation of platelets (clotting factors in the blood) which leads to blood clots (thrombosis)
destabilisation of the heart rhythm
These effects not only promote atherosclerosis, but also increase the risk of heart attack and stroke.
Many people who smoke also overeat, drink heavily and don’t exercise, further adding to their risk of CAD.
Passive smoking is associated with a 25% to 35% increase in risk, even with relatively small amounts of inhaled smoke.
CAD is only one of the evils caused by smoking. Other diseases associated with smoking include lung cancer and emphysema, stroke and intermittent claudication (part of peripheral vascular disease – which is disease of the smaller vessels in the peripheral parts of the body, usually the legs and feet).
- (The Heart and Stroke Foundation/Health24, updated June 2008)