Smoking can cause temporary high blood pressure. This is primarily due to the effects of nicotine. People who smoke regularly may spend much of the day with high blood pressure.

Research indicates that nicotine — the main active ingredient in cigarette smoke — stimulates the release of epinephrine and norepinephrine, which are hormones that increase blood pressure.

Quitting smoking can reduce high blood pressure and lower the risk of heart attack and stroke.

This article discusses the link between smoking and high blood pressure, along with how people can prevent high blood pressure. It also examines whether quitting smoking can reduce high blood pressure and where to get support.

person checking their blood pressureShare on Pinterest
Marko Geber/Getty Images

Every time a person smokes, it produces a temporary increase in blood pressure.

While smoking is a proven risk factor for heart attack and stroke, researchers have yet to determine its overall effect on blood pressure. Despite this, the Centers for Disease Control and Prevention (CDC) still considers smoking a risk factor for high blood pressure.

High blood pressure affects more than 1 billion people across the globe. However, the condition usually produces no signs or symptoms, so a person may not know they have it.

What is blood pressure?

Blood pressure measures the force of blood against the walls of the arteries, the blood vessels that carry oxygen-rich blood to all body parts.

Blood pressure measurements involve two numbers. The first number, systolic, denotes the pressure within the arteries during a heartbeat. The second number, diastolic, denotes the pressure in the arteries when the heart rests between each beat.

Normal blood pressure is less than 120/80 millimeters of mercury (mm Hg). Some doctors define high blood pressure as a reading consistently higher than 130/80 mm Hg, but others define it as a reading consistently higher than 140/90 mm Hg.

Research on the link between smoking and high blood pressure has a few inconsistencies. For instance, a 2018 study exploring the effect of smoking on high blood pressure in people in Indonesia did not find an association.

Conversely, research from 2020 did find a link between smoking and an increased risk of masked high blood pressure. This refers to blood pressure that is normal in a doctor’s office but high during daytime hours when away from a healthcare setting.

Typically, smoking one cigarette raises a person’s heart rate and blood pressure for 15–30 minutes. So, when people smoke frequently, this effect happens over and over throughout the day.

Since a person’s blood pressure in a doctor’s office is away from the influence of smoke, it can appear normal here. Yet it is usually elevated during the day when they smoke.

Smoking two cigarettes per hour can lead to a 5–6 mm Hg increase in daytime blood pressure.

Masked high blood pressure poses a very dangerous risk. It may increase the risk of a heart attack or stroke as much as sustained high blood pressure does.

Research indicates that nicotine can raise blood pressure because it stimulates the release of epinephrine and norepinephrine. These hormones underlie a person’s fight-or-flight response.

Epinephrine and norepinephrine can cause the smooth muscles in certain blood vessels to contract, narrowing the opening and reducing the space through which blood can flow. The result is increased blood pressure.

Smoking — as well as exposure to secondhand smoke — can also damage the walls of blood vessels and raise the likelihood of atherosclerosis.

Atherosclerosis refers to the accumulation of fatty substances called plaque inside the arteries. Consequently, plaque buildup can narrow the blood vessels and contribute to high blood pressure.

The CDC offers some recommendations that can help prevent high blood pressure. These include:

  • Eat a nutritious, balanced diet: This involves eating plenty of fruits and vegetables while limiting intake of salt and saturated fat.
  • Exercise regularly: Aim to get at least 30 minutes of moderate exercise at least 5 days per week.
  • Maintain a moderate weight: Overweight and obesity increase the risk.
  • Get enough sleep: Adequate sleep helps keep the blood vessels and heart healthy.
  • Limit alcohol intake: To maintain healthy blood pressure, males can limit their intake to no more than two alcoholic drinks per day and females can limit their intake to no more than one alcoholic drink per day.

Earlier studies examining the effect of quitting smoking programs on high blood pressure are inconclusive. However, researchers are still trying to determine the relationship between both.

One study from 2021 investigated the effects of a quitting smoking program with 721 participants in Taiwan from 2017–2018. The results suggest that the program significantly lowered both systolic and diastolic blood pressure. Greater reductions were found in people with high blood pressure than in people with normal blood pressure.

Despite any possible inconclusiveness about the effect of quitting smoking on high blood pressure, smoking remains the most preventable cause of premature death in the United States.

Avoiding smoking, and exposure to secondhand smoke, can typically improve general health and decrease the risk of other health complications. In fact, regardless of how long a person has smoked, quitting can help a person breathe better and lower their risk of disease.

Learn more about the benefits of quitting smoking.

Efforts to quit smoking are four times more likely to succeed with support.

The CDC offers the following to smokers seeking assistance:

  • Counseling: This can help with making a quitting plan, along with preparing to cope with urges to smoke. A person can choose group or individualized one-to-one counseling sessions.
  • Medication: A person may wish to ask their doctor whether they could benefit from nicotine replacement therapy.
  • Quitline coaching: People can receive free, confidential coaching via the phone from a trained professional. The number is 800-QUIT-NOW.

Additionally, joining a support group can provide encouragement and motivation. The following are some options:

Below are some questions and answers about high blood pressure and smoking.

Can vaping cause high blood pressure?

Vaping refers to the use of electronic cigarettes (e-cigarettes), which are battery-operated devices that allow someone to inhale and exhale an aerosol. These devices may contain dangerous levels of nicotine, neurotoxins, chemicals, and metals.

No tobacco product is safe. In fact, research from 2021 suggests that e-cigarettes may increase the risk of high blood pressure.

After quitting, why do some people still have high blood pressure?

Smoking is only one risk factor for high blood pressure. Other factors can keep blood pressure too high even after quitting. These may include:

  • age
  • genetics
  • obesity
  • diet, such as consuming high levels of salt

What happens when a person who already has high blood pressure smokes?

Separately, smoking and high blood pressure increase the risk of heart attack and stroke. However, when a person with high blood pressure smokes, it can accelerate the harmful effects, dramatically increasing health risks.

Smoking can raise a person’s blood pressure temporarily. It may also be responsible for masked high blood pressure.

Research on this topic remains inconclusive. However, experts still advise people to be wary of the health effects that smoking has on the body.

Also, smoking can lead to atherosclerosis, increasing the risk of heart attack and stroke. Smoking is the top cause of premature death in the United States.

Quitting smoking can help reduce high blood pressure. Several sources of support are available to aid a person in quitting, including counseling, medication, and quitline coaching.

Other lifestyle strategies may help prevent high blood pressure, such as eating a balanced diet and exercising regularly.