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Heart Health, Explained

Smoking: Smoking Cessation and Reduced Cardiovascular Disease Risk

A new study on reduced cardiovascular disease risk as a result of quitting smoking, presented at the American Heart Association annual meeting and reported November 20, 2013 by Reuters, found that some smokers over 65 who kick the habit may be able to reduce their risk of dying from heart-related problems to the level of never-smokers faster than previously believed.

Smoking Cessation Q&A

Q: How much and how quickly can I reduce my cardiovascular disease risk if I stop smoking?

A: Among people who smoke, the greatest contributor to cardiovascular disease risk is their smoking, when compared with other factors such as high blood pressure, cholesterol levels, and diabetes. Quitting smoking can significantly decrease the risk of heart attack, sudden cardiac death, and stroke for both individuals with and without a prior history of heart and vascular disease. Within a year of stopping smoking, heart and vascular risk can decrease by nearly 50 percent. Five years after quitting smoking, the risk drops to nearly the same risk as for persons who never smoked, though the added risk of heart disease from smoking is never completely eliminated. The overriding message is that stopping smoking improves health and decreases cardiovascular disease risk substantially.

Reference: Hurt RD, Weston SA, Ebbert JO, McNallan SM, Croghan IT, Schroeder DR, Roger VL. Myocardial infarction and sudden cardiac death in Olmsted County, Minnesota, before and after smoke-free workplace laws. Arch Intern Med. 2012;172 (21):1635

Q: I am a woman who smokes, and I’ve heard it may be harder for women than men to quit. What accounts for this difference?

A: Women can metabolize nicotine more quickly than men, making it easier for them to become dependent on nicotine. Once they become dependent on smoking, women can find it more difficult than men to quit smoking for several reasons. First-line smoking cessation medications using nicotine replacement therapies (such as nicotine patch or gum) do not appear to be as effective for women. This is because, in addition to experiencing nicotine withdrawal that causes cravings for cigarettes, women find it difficult to quit because they use smoking, more so than men, to reduce negative mood and anxiety, and to manage stress, appetite and concerns about weight gain. Moreover, women can be more easily drawn back to smoking by external cues such as being around other smokers, seeing someone light up, and even the smell of a lit cigarette. If their partner smokes, it can be particularly hard for women to quit.

Resource: WHRY Video: It’s Harder for Women to Quit Smoking

Q: Are there studies suggesting how women can increase their chances for success in quitting?

A: Recent and ongoing studies indicate that there are ways for women to improve their chances for success in quitting. Emerging evidence points to the fact that support from family, friends, and their partner in the quit attempt can play an important role in whether a women succeeds at quitting. Menstrual cycle factors can play a role, and recent research is attempting to determine whether success at quitting varies by when women attempt to quit during their cycle. Counseling to deal with negative mood and concern about weight gain can help improve a woman’s chance for success at quitting. Regular exercise can be quite helpful, as well as attention to a healthy diet. Most of the time it is not advisable to try to lose significant amounts of weight during a cessation attempt, however. Evidence shows that women who accepted a modest amount of weight gain when quitting actually gained the least amount of weight and were more successful in quitting. Combining counseling with either a health professional or telephone Quitline, along with FDA-approved medication (bupropion, nicotine replacement therapy, varenicline) for smoking cessation also can greatly increase the chance of success.

Resource: SmokeFreeWomen (sponsored by U.S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute) Smoking and Mood


Answers to your questions on timely topics in cardiac care to help make sense of research reports in the media. The series includes questions on your heart and the effect of medications, exercise, diet, and hormones.

Team Specialist

Tom Houston, MD, FAAFP, FACPM, Smoking Cessation Program, McConnell Heart Health Center, OhioHealth Healthcare System, Columbus, Ohio

Q&A Editor

Teresa Caulin-Glaser, MD, FACC, FAACVPR System Vice President, Heart & Vascular Services OhioHealth Healthcare System, Columbus, Ohio

Heart Health Explained is a collaboration of Women’s Health Research at Yale and the OhioHealth Healthcare System, a nationally recognized not-for-profit organization with providers across 46 counties, offering a holistic approach to prevention, treatment and rehabilitation of heart disease. OhioHealth is staffed by physicians, psychologists, nutritionists and nurses who answer the questions of the moment on heart and vascular health.

The information provided here may help you make more informed choices. However, it is not a substitute for an individualized medical opinion or diagnosis, and everyone should always consult with their personal physicians to make decisions about their condition or treatment.