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Tobacco

May 2007

Using tobacco kills

  • If smoking did not exist, then there were would 1.62 million fewer cardiovascular deaths.1
  • Using tobacco causes stiffening and clogging of the arteries, heart disease, stroke, sudden death, and heart failure.2
  • A quarter of tobacco-related deaths are accounted for by ischemic heart disease (IHD).3
  • Cardiovascular disease (CVD) risk increases with the number of cigarettes smoked each day4 leading to a twofold risk of death among smokers compared to non-smokers.3
  • The risk of CVD persists even at one to two cigarettes smoked a day.5
  • Young smokers are particularly at risk of CVD, especially young men.6
  • Smoking more than 25 cigarettes a day increases a person’s risk of heart attack 8 times compared to people who never smoke.7
  • The risk of a non-fatal heart attack increases by 5.6% for every additional cigarette smoked.6
  • Women smokers who use oral contraceptives have a high risk of heart disease, so much so that doctors have been advised not to prescribe the pill to smokers over 34 years old and especially not to smokers over 39 years old.8
  • Smoking 15 cigarettes a day can increase the risk for stroke by up to four times.9
  • Smoking leads to high blood pressure and causes complications in established high blood pressure.10
  • Chewing tobacco more than doubles the risk of heart attack.6
  • The Swedish smokeless tobacco, snus, is linked to CVD.11

Passive smoking, second hand smoke, environmental smoke – a CVD risk by another name

  • There is no risk-free level of exposure to secondhand smoke (SHS).12
  • The excess risk of coronary heart disease (CHD) from passive smoking could be as high as 60%.13
  • Globally, 700 million children are exposed to SHS, that is about half of the world’s children.14

Smoke-free living

  • Within two years of quitting, the risk of CHD is substantially reduced.15
  • 15 years after quitting the risk of CVD returns to that of a non-smoker.2
  • The earlier one stops the better: stopping smoking at age 50 halves the risk of a tobacco-related death, and cessation at age 30 avoids almost all of it.3
  • Smokers who quit at age 35 live up to 8.5 years longer for men and up to 7.7 years longer for women than people who continue to smoke.16

Quitting when older is still worthwhile: among smokers who quit at age 65 years, men gained up to 2.0 years of life, and women gained up to 3.7 years.16

1 Ezzati M, Henly SJ, Thun MJ, Lopez AD. Role of smoking in global and regional cardiovascular mortality. Circulation. 2005; 112: 489–497.

2 Centers for Disease Control and Prevention. The health consequences of smoking: a report of the Surgeon General. Atlanta, Ga. Dept. 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.

3 Doll R, Peto R, Boreham J, Sutherland I. Mortality in relation to smoking: 50 years' observations on male British doctors. BMJ. 2004;328(7455):1519.

4 Emberson JR, Whincup PH, Morris RW, Wannamethee SG, Shaper AG. Lifestyle and cardiovascular disease in middle-aged British men: the effect of adjusting for within-person variation. Eur Heart J. 2005;26(17):1774-82.

5 Vollset SE, Tverdal A, Gjessing HK. Smoking and deaths between 40 and 70 years of age in women and men. Ann Intern Med. 2006;144(6):381-9.

6 Teo KK, Ounpuu S, Hawken S, Pandey MR, Valentin V, Hunt D, Diaz R, Rashed W, Freeman R, Jiang L, Zhang X, Yusuf S; INTERHEART Study Investigators. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: a case-control study. Lancet. 2006;368(9536):647-58.

7 Kabagambe EK, Baylin A, Campos H. Nonfatal acute myocardial infarction in Costa Rica: modifiable risk factors, population-attributable risks, and adherence to dietary guidelines. Circulation. 2007 Mar 6;115(9):1075-81.

8 Keeling D. Combined oral contraceptives and the risk of myocardial infarction. Ann Med. 2003;35(6):413-8.

9 Kurth T, Kase CS, Berger K, Gaziano JM, Cook NR, Buring JE. Smoking and risk of hemorrhagic stroke in women. Stroke. 2003;34(12):2792-5.

10 McAlister FA, Lewanczuk RZ, Teo KK Resistant hypertension: an overview. Can J Cardiol. 1996 Sep;12(9):822-8.

11 Critchley JA, Unal B. Is smokeless tobacco a risk factor for coronary heart disease? A systematic review of epidemiological studies. Eur J Cardiovasc Prev Rehabil. 2004;11(2):101-12.

12 Centers for Disease Control and Prevention. The health consequences of involuntary exposure to tobacco smoke: a report of the Surgeon General. Centers for Disease Control and Prevention, Atlanta, Ga. U.S. Dept. of Health and Human Services, Coordinating Center for Health Promotion, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2006.

13 Whincup PH, Gilg JA, Emberson JR, Jarvis MJ, Feyerabend C, Bryant A, Walker M, Cook DG. Passive smoking and risk of coronary heart disease and stroke: prospective study with cotinine measurement. BMJ. 2004;329(7459):200-5.

14 J Mackay, G Mensah, Atlas of Heart Disease and Stroke.  World Health Organization. Geneva, 2004.

15 Centers for Disease Control and Prevention. Women and Smoking: A Report of the Surgeon General. Atlanta, Ga. U.S. Department of Health and Human Services, CDC, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. 2001.

16 Taylor DH Jr, Hasselblad V, Henley SJ, Thun MJ, Sloan FA. Benefits of smoking cessation for longevity. Am J Public Health. 2002;92(6):990-6.