Smoking & Your Heart

How common is smoking in women?

A smoker is anyone who has smoked 100 cigarettes in his or her lifetime and who still smokes one or more cigarettes a day. More than 20 million American women smoke. In the 1970s, smoking levels began to decline in US adults, but the decline among women slowed down in the 1990s. Nearly 80% of smokers begin before age 18. Currently, about 25% of girls in grades 9 to 12 smoke.

Levels of Smoking Among Women

Source: American Heart Association Heart Disease & Stroke Statistics

People in the US who smoke 44.3 million
Women in the US who smoke 20.2 million
Women Who Smoke By Race
White 20%
Black or African American 17%
Hispanic or Latina* 11%
Asian* 5%
American Indian/Alaska Native* 29%
Figures for adults 18 years and older, 2004; *1999-2001

How does smoking affect my heart?

Smoking damages your heart in several ways:

  1. The chemicals in cigarettes damage the walls of the arteries around your heart. This causes the buildup of fatty plaque that can harden and narrow the arteries. Smoking can also trigger these fatty plaques to burst and block the artery, causing a heart attack.
  2. Smoking makes the blood more likely to thicken and clot, increasing your risk of a heart attack.
  3. Smoking may trigger coronary spasms where the blood vessels of the heart are pinched or narrowed, causing chest pain or a heart attack.
  4. The nicotine in cigarettes stimulates the release of chemicals that can raise your blood pressure.
  5. Smokers tend to have high levels of LDL (bad) cholesterol and triglycerides — two types of blood fat that increase your risk of heart disease. Smoking also lowers HDL (good) cholesterol.

Does smoking increase my risk of heart attack or dying from heart disease?

A study that followed nearly 120,000 women nurses aged 30 to 55 for 12 years found that those who smoked were 4 times more likely to suffer a heart attack or die from heart disease than nonsmokers. The risks were even higher for women who started smoking before the age of 15—they were 9 times more likely to suffer heart problems. Smoking appears to be particularly harmful for young women. A combined analysis of 14 studies of heart disease patients showed that more than 70% of the women 45 years or younger were smokers.

Is smoking more harmful to women than men?

Smoking appears to increase a woman’s risk of heart disease more so than a man’s. In one study, smoking increased the risk of having a heart attack 57% more in women than in men. In general, women – especially younger women – have a lower risk of heart disease than men. Smoking seems to cancel out this natural protection.

Is light smoking harmful?

You don’t have to be a heavy smoker to be at risk; even light smoking is harmful. In the Nurses Health Study mentioned earlier, smoking just 1 to 4 cigarettes a day doubled the risk of having a heart attack or dying from heart disease.

Will quitting smoking help my heart?

Yes. Within 2 years of quitting, your risk of heart disease is cut by one third. After 10 to 14 cigarette-free years, your risk of heart disease is the same as a woman who never smoked. If you have already had a heart attack or been diagnosed with heart disease, it is even more important to stop smoking. Within 5 years of stopping , your risk of dying is cut by 36% compared with heart patients who continue to smoke.

Will cutting back help my heart?

Cutting back on the number of cigarettes you smoke does not seem to lower your risk of heart disease. This is because smoking even a few cigarettes a day is harmful to the heart. Some of the damage that smoking causes occurs the minute you light up – the blood thickens and the arteries stiffen. The Surgeon General’s Report on the Health Consequences of Smoking notes that cigarettes with lower yields of tar and nicotine have not been shown to lower your risk of heart disease and should not be considered lower-risk alternatives to regular cigarettes.

How else is smoking bad for your health?

Smoking also increases your risk of some cancers, particularly lung cancer. It is the major cause of respiratory problems, including emphysema. If you smoke, you are more likely to suffer a stroke or experience clots in the blood vessels of the legs (peripheral arterial disease), making it painful to walk. Women who smoke have a higher risk of osteoporosis (bone loss) and they may go through the menopause at a younger age than nonsmokers. Smoking is also linked to difficulty getting pregnant and problems during pregnancy such as having a premature baby.

Quitting Smoking :

How do I quit smoking?

Quitting smoking is one of the most important things you can do for you health, cardiovascular and otherwise. It is not easy to quit smoking. Many women have to try a few times before they are able to quit for good. Most people relapse in the first 3 months. If this happens, don’t despair – just try again.

Quitting smoking may be more difficult for women than for men. Many women are concerned that they will gain weight if they quit smoking. Women also differ from men in how they respond emotionally and physically to smoking cigarettes. Smoking cigarettes improves a woman’s mood, making it more difficult for her to quit. That is why it is not a good idea to quit smoking before your period, because you may mistake premenstrual symptoms such as anxiety and irritability as symptoms of smoking withdrawal. Furthermore, women’s bodies process nicotine differently, suggesting that nicotine replacement treatment should be tailored differently for women.

Will I gain weight if I quit?

Women may gain 6 to 12 pounds in the year that they quit smoking. However, bear in mind that almost 60% of people who continue to smoke will gain weight too. The health risks of smoking far outweigh the risks of gaining some weight. Don’t let the fear of gaining a few pounds stop you from quitting smoking and significantly improving your health.You can help prevent weight gain by exercising and eating a healthy diet. Some types of smoking aids (nicotine gum and Zyban) help delay weight gain.

Are there medicines to help me quit?

Yes. The Food and Drug Administration (FDA) has approved various types of nicotine replacements to help you quit smoking. These reduce your urge to smoke by providing the nicotine that you would normally crave from cigarettes. They include:

  • Nicotine patch—worn on the skin and supplies a steady amount of nicotine to the body through the skin, e.g., Nicoderm
  • Nicotine gum—chewing releases nicotine into the bloodstream through the lining in your mouth, e.g., Nicorette
  • Nicotine nasal spray—sprayed into your nose and passes into your bloodstream, e.g., Nicotrol
  • Nicotine inhaler—inhaled through the mouth and is absorbed in the mouth and throat, e.g., Nicotrol

You can buy some of these over the counter at your pharmacy, but you will need a prescription for the inhaler and nasal spray. There is also a pill that helps you quit smoking called bupropion (Zyban). It is an antidepressant that helps ease withdrawal symptoms. Zyban is available by prescription only.

When used correctly, these medications are equally effective at helping you quit for good. They can double your chances of quitting. Nicotine replacements contain much lower amounts of nicotine than cigarettes and none of the other harmful chemicals. You should follow the instructions on dosing so that you gradually wean yourself off the nicotine replacement product.

Resources for Quitting

National Alliance for Tobacco Cessation:

Surgeon General US Department of Health & Human Services:

National Smoking Quitline:

Centers for Disease Control & Prevention:

Secondhand Smoke & Pregnancy :

Does secondhand smoke increase my risk for heart disease?

Yes. Studies from the mid-1980s and later show that secondhand smoke increases the risk of heart disease by 25% to 30% in men and women who do not smoke. Earlier research did not show such a dramatic effect mainly because they were done before laws were passed to cut industrial pollution or smoking in the workplace. This meant it was likely that the control group was also exposed to smoke at work or outdoors. On top of that, one analysis found that the studies showing that secondhand smoke was harmless tended to be written by people with ties to the tobacco industry. Secondhand smoke includes:

  • Sidestream smoke – the smoke that comes from the tip of a burning cigarette
  • Mainstream smoke – the smoke that is inhaled and then exhaled by smokers

Unlike the case with lung cancer, the risk of heart attack and heart disease rises rapidly at low doses of tobacco smoke. After 20 minutes’ exposure to secondhand smoke, the blood of nonsmokers thickens, making it more likely to clot (and potentially trigger a heart attack). Sidestream smoke has a stronger blood thickening effect than mainstream smoke. After 15 to 30 minutes’ exposure, the arteries are stiffer. Spending 2 hours in a smoking room increases the risk of heart rhythm problems.

Do smoke-free policies reduce heart disease?

Smoke-free policies such as a ban on smoking in the workplace have helped reduce nonsmokers’ exposure to tobacco smoke. Scientists can confirm this by measuring blood levels of cotinine, a breakdown product of nicotine (nicotine doesn’t stay in the blood long enough to be recorded over time).There was a 75% reduction in blood levels of cotinine in nonsmokers from 1999-2002 compared with 1988-1991. It is too early to tell whether this will translate into a dramatic reduction in the risk of heart disease and heart attack. One interesting study comes from the small town of Helena, Montana, where a law banning smoking in public places was passed and then challenged and reversed. When the ban was in place, the number of people hospitalized for heart attack fell to 24 from an average of 40 in the same month the years before the law was in place. Once the law was reversed, the number of heart attacks rose again.

Does smoking during pregnancy harm the baby?

Yes. It is very important to quit smoking if you are pregnant. Smoking impairs the baby’s growth and development. Women who smoke during pregnancy have a higher risk of going into labor early or having a low-weight baby.

Can I use medications to help me quit if I’m pregnant?

If you are pregnant, you should not use nicotine replacements or Zyban unless your healthcare provider has told you to. There is not a lot of safety information on the use of these medications during pregnancy.

What if I quit smoking during my pregnancy but start up again after the baby is born?

Up to 85% of women who quit smoking at some stage during pregnancy continue to smoke after the baby is born. Many women are motivated to quit for the health of their unborn baby, but a mother’s smoking also poses risks for the baby after he or she is born. Babies born to mothers who smoke heavily are more likely to be hospitalized in their first 8 months (for respiratory or stomach problems) than babies born to nonsmoking moms. Having a smoking mother increases a baby’s risk of sudden infant death syndrome (SIDS, or crib death) 2- to 4-fold. Women often put their family’s needs first but, remember, if you neglect your own health, you may not be well enough to look after your family. Not smoking also sets an example for your children and increases the likelihood that they won’t start smoking.


  1. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure:

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