Cardiovascular disease (CVD) and smoking

Last updated: 29 September 2007

What is cardiovascular disease (CVD)?

The heart needs a steady supply of blood to function effectively. Cardiovascular disease is a general term that describes conditions caused by an interrupted or diminished blood flow through the coronary arteries to the heart muscle. The main cardiovascular diseases are heart attack, angina, stroke and peripheral vascular disease (PVD). As a group, these diseases are the leading cause of death in Australia. In 2001, an estimated 3.2 million Australians, or 17 per cent of the population, suffered from cardiovascular conditions.

The role of smoking in cardiovascular disease

Tobacco smoking is considered a major risk factor for cardiovascular disease and nearly 40% of all the people who die from smoking die from heart, stroke or blood vessel (cardiovascular) disease. Research shows that both directly inhaled tobacco smoke and passively inhaled tobacco smoke increase the risk of developing cardiovascular disease.

Smoking increases the artery clogging process called atherosclerosis. The narrowing of the arteries limits blood-flow and means that less oxygen is supplied to the body. If atherosclerosis narrows any of the heart's coronary blood vessels, this can lead to angina or a heart attack. Stroke occurs when an artery supplying blood to a part of the brain suddenly becomes blocked. There is no 'low-risk' level of smoking; both 'social' smoking (less than five grams of tobacco per day) and smoking without inhaling increase the risk of heart disease.

Smoking increases the risk of:

• heart attack by two to six times
• heart disease in women, particularly those on the oral contraceptive pill
• stroke by three times.

Peripheral vascular disease (PVD)

Peripheral vascular disease is a form of cardiovascular disease. PVD can occur in the arteries of the hands, legs and feet and usually affects older people. In 2001, PVD claimed more than 2,000 Australian lives.

Because PVD develops slowly, like many other smoking-related diseases, some people do not show any signs of the disease even though they may have it. Other people may feel pain when they are walking or pain while they are resting, especially if they are cold. In severe cases, reduced blood supply can lead to amputation.

Smoking is the most powerful risk factor for developing PVD and the disease is made worse by smoking. Quitting smoking improves exercise tolerance, reduces risk of amputation and increases overall survival.

Stroke

Smokers are more likely to develop a cerebral thrombosis (stroke) than non-smokers. About 11% of all stroke deaths are estimated to be smoking related, with the overall relative risk of stroke in smokers being about 1.5 times that of non-smokers. Heavy smokers (consuming 20 or more cigarettes a day) have 2-4 times greater risk of stroke than non-smokers. A recent study showed that passive smoking, as well as active smoking, significantly increased the risk of stroke in men and women.

It's never too late

It's never too late to quit smoking, even if you already have some form of cardiovascular disease. Quitting smoking is the best investment you can make in your health. The sooner you quit the better. Even if you have already experienced some health damage caused by smoking it is still possible to reverse some of the effects.

Quitting can reduce the chance of having a repeat heart attack or stroke and other forms of heart disease. After quitting, the risk of stroke may return to the level of someone who has never smoked within five years. Fifteen years after quitting, the risk of heart disease is similar to that of a person who has never smoked.

When you are ready to try, ring the Quitline 131 848 (local call cost). The fact sheet Getting ready to quit has more information.

References

1. Australian Institute of Health and Welfare (AIHW) 2003, About Cardiovascular Disease, AIHW.

2. US Department of Health and Human Services 1983, The Health Consequences of Smoking - Cardiovascular Disease, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, Rockville, Maryland 20857.

3. English DR, Holman D et al 1995, The quantification of drug-caused mortality and morbidity in Australia, Commonwealth Department of Human Services and Health, Canberra, AGPS.

4. Otsuka R, Watanabe H, Hirate K, et al 2001, Acute effects of passive smoking on the coronary circulation in health young adults, Journal of the American Medical Association, 286(4): 436-41.

5. Prescott E, Scharling H, Osler M, Schnohr P 2002, Importance of light smoking and inhalation habits on risk of myocardial infarction and all cause mortality, A 22 year follow up of 12,149 men and women in The Copenhagen City Heart Study, J Epidemiol Community Health, 56:702-706.

6. Willet W, Creen A, Stampfer M et al 1987, Relative and absolute risks of coronary heart disease among women who smoke cigarettes, New England Journal of Medicine, 317:1303.

7. Bonita R, Scragg R, Stewart A et al 1986, Cigarette smoking and risk of premature stroke in men and women, British Medical Journal Clinical Research Ed, 293(6538):6-8.

8. Australian Institute of Health and Welfare (AIHW) 2003, Peripheral Vascular Disease., AIHW.

9. Shinton R, Beevers G 1989, Meta-analysis of relation between cigarette smoking and stroke, Br Med J, 298:789-94.

10. Smith PEM 1998, Smoking and stroke: a causative role, editorial, Br Med J, 317:962-3.

11. Bonita R et al 1999, Passive smoking as well as active smoking increases the risk of acute stroke, Tobacco Control, 8:156-160.

12. US Department of Health and Human Services 1990, The Health Benefits of Smoking Cessation, US Department of Health and Human Services, Public Health Service, Centers for Disease Control, Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, DHHS Publication No. (CDC) 90-8416.

13. Wolf PA et al 1988, Cigarette smoking as a risk factor for stroke, JAMA, 259: 1025-29.

Further Information

• Quitline  http://www.quitnow.info.au
• Getting ready to quit  http://www.health.nsw.gov.au/factsheets/general/readyquit.html