Hem » Articles » Health » Clearing the Air: The Link Between Smoking and Cardiovascular Health

At NEM, we want to draw attention to the important parts of heart health by publishing a series of articles. In this article,we focus on the critical aspect of avoiding smoking. While smoking is commonly associated with lung cancer, its impact on cardiovascular health is often underestimated. Let’s investigate the profound effects of smoking on heart health and why it deserves our attention.

If you missed our introduction to heart health, that can be found here

Smoking stands out as a significant contributor to cardiovascular diseases (CVD) in the United States, earning its place on Life’s Essential 8 list as a key factor affecting cardiovascular health (Figure 1) (1).  With over 16 million individuals in the USA affected by diseases linked to smoking, its impact is substantial  (2).  While Sweden experiences lower smoking rates, this article aims to raise awareness and highlight the potential positive effects of policy interventions.

Figure 1: Life’s Essential 8: healthy diet, participation in physical activity, healthy levels of blood lipids, glucose and blood pressure, healthy weight, avoidance of nicotine, and healthy sleep. Adopted from (1).

Smoking in Sweden

Sweden is on the path to achieving a groundbreaking milestone by becoming the world’s first nation to give up cigarettes (6). This achievement, 17 years ahead of the EU target date, is attributed to Sweden’s adoption of harm-reduction strategies in tobacco control. By making non-combustible alternatives like snus, oral nicotine pouches, and e-cigarettes accessible and acceptable, Sweden significantly reduced tobacco-related mortality rates, leading to lower cancer rates and deaths compared to other countries. The success of Sweden’s approach provides a realistic roadmap for creating a smoke-free world, potentially saving millions of lives globally.

Sweden statistics (6): 

  • Over the past 15 years, Sweden has slashed its smoking rates from 15% in 2008 to 5.6% in 2023.
  • The EU’s average smoking rate is currently 23% – almost five times higher than Sweden’s. In many EU countries, one in three people still smokes.
  • Sweden has a 40% lower rate of death from all tobacco-related diseases compared to the EU average.

However, many countries still face the negative impacts of smoking. Whether you smoke, know someone who does, or are curious about the link between smoking and CVD, keep reading.

Smoking causes cancer, heart disease, stroke, lung disease, diabetes, and chronic obstructive pulmonary disease (2). Smoking also increases the risk of tuberculosis, certain eye diseases, and problems of the immune system, including rheumatoid arthritis.

One in every four deaths from CVD is attributed to smoking (3).  

Smoking is related to CVD in several ways. Smoking has the potential to (1):

  • Elevate triglycerides, a form of fat present in the blood
  • Reduce levels of “good” cholesterol (HDL)
  • Induce “stickiness” in the blood, increasing the likelihood of clot formation, which can obstruct blood flow to the heart and brain
  • Harm the cells that line the blood vessels
  • Enhance the accumulation of plaque (fat, cholesterol, calcium, and other substances) within blood vessels
  • Trigger thickening and narrowing of blood vessels

A recent study published in the Journal of the American Heart Association examined the impact of smoking on cardiovascular health (4). It included data from over 100,000 individuals and analyzed the long-term risks associated with smoking and different CVDs. Although it is well established that smoking is associated with cardiovascular and non-cardiovascular morbidity and mortality, the study indicated that smoking is linked to an increased risk of fatal and nonfatal CVD events across different age groups and genders. Additionally, the study highlighted that smoking is associated with an earlier onset of CVD and a higher risk of fatal CVD events as the first manifestation of the disease. Overall, the study emphasized the significant impact of smoking on cardiovascular health and the importance of addressing smoking cessation to reduce CVD risk.

Another study investigated the association between smoking and various causes of death in a large population (421,378 men and 532,651 women 55 years of age or older) over 11 years (3). The study found that smoking is linked to an increased risk of death from several diseases not traditionally known to be caused by smoking. These include infections, intestinal ischemia, hypertensive heart disease, renal failure, other respiratory diseases, and liver cirrhosis. The study suggests that the number of deaths caused by smoking could be significantly higher than current estimates. Overall, the findings highlight the potentially greater impact of smoking on mortality than previously thought.

Smoking significantly harms our health, increasing the risk of heart problems and other severe conditions. Quitting smoking is crucial for reducing the risk of heart disease.  

It is important to emphasize that secondhand smoke- smoke from burning tobacco products and the smoke breathed out by a smoker,  also harms health (5). Secondhand smoke causes stroke, lung cancer, and coronary heart disease, including heart attack and stroke in adults (2), (1). 

In conclusion, understanding the detrimental effects of smoking on cardiovascular health is crucial for prevention and overall well-being. As we shed light on this aspect, avoiding smoking is not only beneficial for lung health but is also essential in preventing CVD. Although smoking in Sweden is less prevalent compared to other countries, some people still need help to quit smoking. At NEM, we are committed to a proactive approach to well-being, emphasizing prevention as a cornerstone of our philosophy. By providing personalized guidance and raising awareness about lifestyle choices, including avoiding smoking, we aim to empower individuals to take charge of their heart health and work towards a healthier, more fulfilling life.

Can’t get enough about heart health? Read our other articles on the components that play a role in achieving and maintaining an optimal heart:

Heart Health Basics

Heart-Healthy Diets

Heart Healthy Activity

Silviya Demerzhan, Ph.D.

Chief Scientific Officer, Nordic Executive Medicine
Medical review by: Dr. Mahir Vazda MD

  1. CDCTobaccoFree. Centers for Disease Control and Prevention. 2023 [cited 2024 Jan 10]. Heart Disease and Stroke. Available from: https://www.cdc.gov/tobacco/basic_information/health_effects/heart_disease/index.htm
  2. CDCTobaccoFree. Centers for Disease Control and Prevention. 2022 [cited 2024 Jan 10]. Health Effects of Smoking and Tobacco Use. Available from: https://www.cdc.gov/tobacco/basic_information/health_effects/index.htm
  3. Carter BD, Abnet CC, Feskanich D, Freedman ND, Hartge P, Lewis CE, et al. Smoking and mortality–beyond established causes. N Engl J Med. 2015 Feb 12;372(7):631–40. 
  4. Cigarette Smoking and Competing Risks for Fatal and Nonfatal Cardiovascular Disease Subtypes Across the Life Course [Internet]. [cited 2024 Jan 10]. Available from: https://www.ahajournals.org/doi/epub/10.1161/JAHA.121.021751
  5. Health Problems Caused by Secondhand Smoke [Internet]. 2023 [cited 2024 Jan 10]. Available from: https://www.cdc.gov/tobacco/secondhand-smoke/health.html
  6. Report the Swedish Experience [Internet]. 2023 [cited 2024 Jan 29]. Available from: https://Report The Swedish Experience EN.pdf  (smokefreesweden.org)