Heart Health

13 January 2009

Smoking and heart disease

Smoking is one of the major risk factors for heart disease and stroke and a leading cause of premature death.

Smoking is one of the major risk factors for heart disease and stroke and a leading cause of premature death. More than half of those who die as a result of smoking do so in middle age – losing 22 years of normal life expectancy.

Half of the smokers who began smoking when they were young will die from tobacco-related diseases. There are three and a half million smoking related deaths each year and this figure excludes those who die as a result of passive smoke exposure.

Of the predicted 10 million smoking-related deaths each year, seven million are in developing countries.

What smoking does to you


  • Doubles your risk of heart attack and doubles it again if you smoke heavily – more than 10 to 15 per day.
  • Doubles your risk of heart disease again if you also have high blood pressure or high blood cholesterol.
  • Increases the risk of heart disease and stroke a further 10 times if you are a woman on the oral contraceptive pill.
  • Increases your risk of gangrene and subsequent loss of limbs, generally through peripheral vascular disease, by over five times.
  • A smoker's risk of coronary artery disease is directly related to the number of cigarettes smoked daily. In people who already have a high risk of heart disease, smoking is particularly dangerous. Specifically, smoking:
    • decreases the level of "good" HDL cholesterol and increases the level of "bad" LDL cholesterol.
    • raises the blood carbon monoxide level, which may increase the risk of injury to the lining of arterial walls.
    • constricts arteries already narrowed by atherosclerosis, further decreasing blood flow to the tissues.
    • increases the blood's clotting tendency, thus increasing the risk of peripheral arterial disease, coronary artery disease, stroke and obstruction of an arterial graft after surgery.
  • Smoking in South Africa

    • For South African men, 30 years or older in 2000, the highest tobacco-related death rate was found in coloureds, followed by Africans and Indians, with the lowest rate in whites.
    • For South African women, 30 years in or older in 2000, the tobacco-related death rate was much lower than for men. The highest rate was also found in coloureds, followed by whites, Africans and Indians.
    • Currently, the highest lung cancer rates in South Africa are found in coloured men and women, reflecting their smoking rates.
    • The Tobacco Products Control Amendment Act of 1999, signed by President Nelson Mandela, created one of the most effective tobacco control policies in the world. Further amendments have been enacted in 2007 to ensure optimal tobacco control in the country.
    • The impact of the tobacco control policies was dramatic. In South Africans, 15 years and older, the smoking prevalence decreased from 32% in 1993 to 24% in 2003.
    • The largest reduction in smoking between 1993 and 2003 occurred in men, African and coloured people, as well as in those with limited education and a low income.

    Want to quit? Read our article on Ways to quit smoking.

    Information from the Heart and Stroke Foundation of South Africa

    - (Updated December 2008)


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