Smoking and heart attacks

Smoking causes heart disease and heart attacks. Learn more about smoking and the impact on your heart.

Smoking causes coronary heart disease

Smoking is a major cause of coronary heart disease, also called ischaemic heart disease.

When you have this disease, the blood supply to your heart muscle is reduced. Coronary heart disease starts gradually. Your heart’s blood vessels become narrow due to a build-up of plaque, which contains fat, cholesterol, and other substances. The plaque reduces blood flow and vital oxygen to your heart muscle.

The forms of coronary heart disease include:

  • heart attacks – these occur when the supply of blood to part of the heart is completely blocked resulting in injury to the heart muscle.
  • angina – a type of chest pain or discomfort that happens when your heart doesn’t get enough blood and oxygen due to narrowing of the coronary arteries. Angina can happen when the heart is working harder than usual, such as when an affected person is active. In more severe coronary artery narrowing, it can start from minimal exertion or even when at rest.

The more cigarettes you smoke, the more likely you are to die from coronary heart disease.

This is especially if you smoke:

  • up to 14 cigarettes a day – you have over double the risk of dying from this disease than non-smokers do
  • over 25 cigarettes a day – you have over 5 times the risk of dying from this disease than do non-smokers.

Even smoking a small number of cigarettes each day or week is dangerous for your heart.  

In Australia, smoking is the cause of a large proportion of deaths from heart disease in younger people. Smoking was the cause of over one-third of the deaths from heart disease for people between 45 and 54 years of age.

It’s not just cigarette smoke that causes heart disease. Other tobacco products, such as shisha and cigars can increase the risk. 

Second-hand smoke also causes coronary heart disease. Your smoke could be causing heart disease in someone you love.

Smoking causes heart attacks

Smoking causes heart attacks which can kill you, and not just when you’re old. 

A heart attack occurs when a blood vessel that supplies blood to the heart gets blocked. This reduces blood flow to the heart. Some of the heart tissue dies, leading to injury of the heart muscle. A heart attack is a serious medical emergency and can cause death.

Heart attacks are a major cause of death in Australia. People who survive a heart attack often find their lives are changed forever, but it’s not just older people who are at risk. People between the ages of 45 and 64 who smoke are almost 3 times more likely to have a heart attack than non-smokers.

Read more about the signs of a heart attack and causes of heart attacks.

What is it like to have a heart attack?

As people who smoke are at greater risk of a heart attack than non-smokers, it’s important that they can recognise the signs. Many people think that a heart attack is a sudden strong pain in the chest. However, this is not the case for everyone.

There are a range of non-chest pain signs that are different from what people may expect. Heart attacks often involve chest pain, but not always. It may begin with feelings of discomfort in the chest. Some people feel pain in their back and arms, or even in their jaw. Some people describe feeling generally unwell. Other signs include being short of breath feeling nauseous, or cold and sweaty.

The key to surviving a heart attack is to know the warning signs and to call triple zero (000) for an ambulance. Don’t delay. It could save your life or the life of a loved one.

Life after a heart attack

If a person has had a heart attack, they will need to manage their risk of further heart problems for the rest of their life.

Immediately after the heart attack, they will usually need to attend a cardiac rehab program. The goal is to help people develop healthy habits that they can continue into the future. This usually includes major changes to lifestyle including physical activity and diet, and may include changes at work. For example, a job involving heavy physical effort may no longer be possible.  

Most people will need to take ongoing medication to reduce their risk of further coronary events.

Read more about recovering from a heart attack.

How does smoking cause coronary heart disease?

Cigarette smoke contains many toxic chemicals and gases. With each draw on a cigarette, these chemicals move into your lungs, and from there into your blood.

Scientists have studied the ways in which these chemicals affect your heart. These changes increase the need for blood to reach your heart muscle yet also reduce the amount that reaches it. Toxic chemicals from smoke narrow your heart’s blood vessels by causing plaques to form in them. This is called atherosclerosis. These plaques are made of fats, cholesterol, and other substances. They harden and clog your blood vessels, causing coronary heart disease and other problems.

Some of the toxic chemicals in smoke that affect your heart are:

Carbon monoxide

This toxic gas takes the place of oxygen in red blood cells. By doing this, it reduces the amount of oxygen in the blood that reaches your heart muscle. This means that more blood flow is required to keep your heart working well.

Nicotine

Nicotine makes your heart work harder. It increases your heart rate, your blood pressure, and the power with which your heart beats. By working harder, your heart muscle needs more oxygen and nutrients, which it struggles to get.

Nicotine also leads to narrowing of your heart’s blood vessels, reducing blood flow.

Oxidants and other chemicals made when cigarettes burn

These chemicals lead to inflammation, increase the chances of blood clots, and tighten the blood vessels leading to your heart. This reduces the oxygen and nutrients that reach your heart muscle.

Quit smoking to reduce your risk of a heart attack

Quitting smoking reduces your risk of coronary heart disease and your risk of having a heart attack. If you are diagnosed with coronary heart disease, quitting smoking reduces your chance of dying from it.

A year after quitting, your extra risk of heart disease from being a smoker is reduced by about half. If you stay quit for 15 years, your risk should return to the same as that of a non-smoker.

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