By Tanner Lambson 

Most of us are aware of this fact, but it’s worth repeating: Smoking is a major risk factor in heart disease.  

In fact, a 2021 study showed that smokers are more likely to die of cardiovascular disease than lung cancer. Compared to a non-smoker, somebody who smokes is two to four times more likely to develop heart disease. 

So, what’s the best way to “start stopping”? 

“You don’t have to do all of this at once,” said Deborah Pora, a nurse practitioner with the VCU Health Pauley Heart Center’s women’s heart health clinic. “One of the things I talk about with my patients is what kind of quit strategy can we make for them. What in your life are you willing to start, and what are you willing to give up?” 

VCU Health News spoke with Pora about how smoking impacts heart health and how to start the process of smoking cessation.  

As a reminder, how does smoking affect your heart?  

The chemicals in tobacco and nicotine products damage your blood vessels and make you more likely to experience plaque buildup in your arteries, which in turn increases your risk for coronary artery disease, heart attack, and stroke.  

Smoking combined with other risk factors for heart disease like high blood pressure, high cholesterol, and/or being overweight and obese, your risk of developing heart disease is magnified even further. 

Do smokeless tobacco products have the same effect on the heart as cigarettes? 

The cardiovascular risks of nicotine products are not limited to traditional forms of tobacco products, like cigarettes, cigars, or chewing tobacco. Smokeless tobacco products such as nicotine pouches like Zyn carry cardiovascular risks, since it is the chemicals in nicotine products that can lead to heart disease – not just the smoke. According to VCU’s Vascular and Integrative Physiology Laboratory, e-cigarettes can also lead to vascular dysfunction. Other research notes that smokeless tobacco products can still cause nicotine addiction and diseases of the mouth. 

How do I quit smoking?  

Quitting is never easy. Smokers who try to quit report the barrage of withdrawal symptoms as intense and even grueling. But even small changes can have a large impact. 

• Cut back gradually. Quitting cold turkey can be very overwhelming for some. Even a reduction in cigarette intake – like going from a full pack to a half-a-pack a day – can still benefit your heart health. 
• Replace smoking with heart-healthy habits. Instead of a smoke break, take a short walk, meditate, or eat a heart-healthy snack. One of my patients took up knitting. It worked for them! 
• Create a support system. Check in with friends and family. Someone you trust supporting you along the way will make quitting more bearable. If you don’t have anyone to help you in your personal circles, try joining a support group or calling a smoking quitline. In Richmond, you can access support groups and personalized coaching through the City of Richmond Free From Tobacco Program or the VCU Massey Cancer Center’s We CAN Quit program. Access a national no-smoking quitline by calling 1-800-QUIT-NOW (1-800-784-8669). If you prefer texting to speaking on the phone, there are also text-based smoking cessation support tools like SmokefreeTXT – text “QUIT” to 47848 to get started. 

What other tools and resources can help me quit smoking? 

Today, there are a lot of tools designed to help you quit. Some I recommend to my patients are nicotine replacement therapies like gum and patches and prescription medications like Chantix and Zyban. A lot of young people also have success with apps to help them quit, like Smoke Free and QuitNow. 

But be aware: There isn’t much data regarding the usefulness of vaping and e-cigarettes as a quitting tool. Try to avoid these, if possible. 

There are many online resources available to help you on your smoke-free journey—check out what’s available from the Centers for Disease Control, American Heart Association, and smokefree.gov. 

What should I do when smoking is usually my stress reliever? 

Manage that stress! The stressors of life may make you feel like you ‘need’ another puff, but the need you are feeling is simply nicotine withdrawal in your brain. The reality is that smoking doesn’t lower stress. In fact, it can increase anxiety and tension. As you quit, throw yourself into your hobbies and use mindfulness exercises to keep stress low. 

What are some of the immediate benefits from quitting smoking?  

Once you stop smoking, your health immediately improves. Twenty minutes after your last cigarette, your heart rate and blood pressure drop. In the next 24 hours, your risk of heart attack and stroke starts to decrease and continues to go down. Over the next few weeks and months, your blood circulation and lung function improve, and your coughing will reduce. Finally, after a year — congratulations! — your risk of heart disease is half that of a smoker.  

It doesn’t stop there — quitting smoking leads to improved generational health as well. When you see a mother or father quit smoking, there’s less likelihood for their children to start. In a way, you can see the positive generational effects of not picking up cigarettes.  

Quitting smoking is one of the best things you can do for your heart health and overall well-being. Even if you’re a lifetime smoker, there are many ways for you to get started. Take just one small step today — set a quit date, reduce your intake, or seek out support from those who want to see a tobacco-free, heart-healthier you. Your heart will thank you for every change you make. 

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