Smoking is a major risk factor for cardiovascular disease and can raise the risk of heart attack and stroke by two to four times, according to Turkish cardiologists.
Dr. Cafer Panç, a cardiologist at Mehmet Akif Ersoy Training and Research Hospital, said smoking is a widely used and highly harmful substance. While most people are aware of its effects on the lungs, he said cardiologists often see far more dramatic consequences tied to smoking.
Panç said cardiovascular disease is the leading cause of death worldwide, killing roughly 20 million people a year, and that smoking is linked to around 7 million of those deaths annually. He said smoking damages blood vessels through multiple mechanisms, including harm to the inner vessel wall that contributes to the onset of arterial stiffening, and by increasing inflammation inside blood vessels, which accelerates that process.
“Damage begins from the very first cigarette”
Panç said smoking’s harmful effects begin not only with regular, long-term use but from the very first cigarette. He noted that the vascular damage caused by a single cigarette can reach 40-50% of the risk posed by an entire pack of 20.
He said quitting before age 40 can reduce smoking-related risks by 80-90%, and that the earlier a person quits, the greater the benefit to the body.
Panç said hookah, e-cigarettes and heated tobacco products all carry cardiovascular risk as well, and that nicotine addiction itself poses a risk for cardiovascular disease. He said the aerosols produced by e-cigarettes contain toxic substances that can negatively affect heart and vascular health, and recommended avoiding all of these products entirely to protect cardiovascular health.
Secondhand smoke raises cardiovascular disease risk by 50%
Panç said that of the 7 million people who die worldwide each year from smoking-related illness, close to 1.5 million are secondhand smokers. “We know that cardiovascular disease increases by 40 to 50% in secondhand smokers compared to those never exposed to smoke,” he said.
He said the harmful effects of smoking diminish over time after quitting. Heart rate returns to normal within minutes, he said, while cardiovascular disease risk begins to drop noticeably within one to two years, falls by nearly half within three to five years, and after 13 to 15 years returns to nearly the level of someone who never smoked.
Panç said even long-term smokers can benefit from quitting, and stressed that regardless of how long someone has smoked, they should quit as soon as possible. He said that to protect cardiovascular health, not even a single cigarette should be smoked.
“Heart rate begins rising within the first 20 minutes”
Dr. Ömer Taşbulak, a cardiologist at Mehmet Akif Ersoy Heart Hospital, said smoking and tobacco use are among the leading causes of cardiovascular disease.
He said coronary heart disease, peripheral artery disease and carotid artery disease affecting the brain’s blood vessels are all directly linked to smoking. “As soon as a person starts smoking, heart rate and blood pressure begin rising within the first 20 minutes,” he said.
Taşbulak said smoking triggers cardiovascular disease by directly damaging endothelial cells lining the inner walls of blood vessels. “Starting from the very first cigarette, this damage can accumulate over the years and cause serious, permanent harm to the organs involved,” he said.
He said that when combined with cholesterol buildup and other factors in vessel walls, smoking can activate atherosclerotic plaques. “If these plaques eventually rupture in the vessels of the heart, it causes a heart attack; if they rupture in the brain’s blood vessels, it causes a stroke, and the same process can trigger damage in other organs as well,” he said. He added that hookah, e-cigarettes and heated tobacco products are no different from cigarettes in this respect, since users still inhale toxic, hot, poisonous smoke that reaches the vascular system and damages endothelial cells in the same way, contributing to atherosclerotic heart disease just as smoking does.
Taşbulak said hookah use exposes users to far heavier smoke than regular cigarettes, while e-cigarettes, due to their ease of use, are often used more frequently than conventional cigarettes.
He also said long-term exposure to secondhand smoke raises cardiovascular disease risk, and that exposure among children, the elderly and people with existing cardiovascular disease can lead to particularly negative outcomes.
“It’s never too late to quit smoking,” Taşbulak said. “Of course, the best outcome is never starting at all — but even if you quit after developing cardiovascular disease, or even after a stroke, remember that this is an ongoing process.”