Can smoking cause heart failure?

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Coronary heart disease, which undermines the blood vessels’ ability to deliver oxygen-rich blood to the heart, is a major risk factor for heart failure.

Heart failure occurs when the heart cannot pump blood around the body efficiently. It is a leading cause of death in the United States. According to the Centers for Disease Control and Prevention (CDC), in 2018, heart failure was listed on 13.4% of U.S. death certificates.

Smoking cigarettes can increase the risk of coronary heart disease. It can also cause other changes in the heart that may elevate the risk of heart failure, such as:

• Increased blood pressure: This can occur suddenly.
• Increased pulmonary artery pressure: The pulmonary artery carries oxygen-poor blood from the heart to the lungs.
• Increased overall vascular resistance: This relates to the force of the blood moving around in the vessels.
• Excess exposure to carbon monoxide: This damages the kidneys and causes oxidative stress — both of these are known risk factors for cardiovascular disease.

In a 2022 study, researchers compared people who had never smoked to former and current smokers. The 9,345 study participants had no history of heart failure at the beginning of the study. Over 13 years, current smokers experienced heart failure at twice the rate of people who had never smoked.

The more frequently and the longer people had smoked, the higher their risk of heart failure was. Also, quitting smoking reduced the risk of heart failure, with greater improvements occurring as people went longer without smoking. Nevertheless, the risk remained elevated for several decades after people quit smoking.

Learn more about the risk factors for heart failure.

The symptoms of heart failure include:

• fluid retention that causes swelling in the feet and legs
• fatigue and breathlessness when performing typical activities
• weakness and tiredness
• difficulty breathing when lying down

The symptoms of heart failure are similar to those of other heart conditions and a range of other conditions that can be mild and non-life-threatening.

The absence of symptoms does not mean a person’s heart is healthy, and the presence of symptoms does not mean a person has heart failure.

People should consult a doctor if they experience any symptoms of heart failure. Regular heart health checkups may be beneficial if someone has heart disease risk factors, such as advanced age or smoking, or has a family history of heart failure.

The toxic smoke from cigarettes damages the heart and blood vessels, both directly and indirectly. The effects include:

• raising the levels of triglycerides, or fats
• lowering good cholesterol and raising bad cholesterol
• making blood sticky and therefore more likely to form harmful clots
• damaging the lining of the blood vessels
• increasing plaque formation in blood vessels
• causing blood vessels to thicken and narrow, which means the heart must work harder to pump blood through them

Secondhand smoke exposes a person to harmful substances such as carbon monoxide, which may lead to:

• increased risk of cardiovascular disease
• increased risk of stroke
• damage to blood vessels

According to the CDC, secondhand smoke causes 34,000 premature deaths from coronary heart disease each year.

The risk is highest for those with chronic, ongoing exposure to secondhand smoke, such as people who are constantly exposed to it at home.

Smoking can potentially damage virtually every organ and system in the body. It is especially harmful to the heart and lungs. Risks of smoking include:

• mouth cancers
• lung cancer
• chronic obstructive pulmonary disease
• infertility
• health and quality of life issues such as having a cough, smelling like smoke, and taking time away from loved ones to smoke

According to a 2013 study, people who smoke may live an average of 10 years less than those who do not, but quitting smoking before age 40 can reduce smoking-related deaths by about 90%. Even later in life, quitting smoking gradually improves health, quality of life, and life expectancy.

The benefits of quitting smoking never disappear. Even in people with lung cancer, quitting smoking is beneficial.

A 2021 study examining people who had a diagnosis of early stage lung cancer found that those who quit lived a median of 22 months longer than those who kept smoking.

The moment a person quits smoking, their body begins to heal. The specific risks change with time and may depend on other health factors.

Overall, though, nonsmokers have a lower risk of disease than smokers with similar risk factors.

Most people who smoke attempt to quit several times before succeeding. It can be helpful to frame each attempt as a learning opportunity.

Several methods can make it easier to quit smoking, such as:

• using nicotine replacement therapy
• using medications such as bupropion and varenicline
• undergoing psychotherapy to ease the stress of quitting

Combining methods, such as using both nicotine replacement therapy and medication, can be beneficial.

Some people switch to electronic cigarettes, but researchers do not yet fully know the risks of e-cigarettes.

Smoking can result in a nicotine addiction. People who are in the process of quitting may wish to consider each moment they spend not using nicotine as an investment in eventually not having an addiction. The longer a person goes without smoking, the easier it may become.

Learn more about quitting smoking.

Smoking damages the heart, blood vessels, and lungs. Over time, this increases the risk of many health conditions, including coronary artery disease and heart failure.

Longtime smokers may worry that the damage has already been done. However, quitting smoking can give the body a chance to begin healing. Quitting smoking may prolong a person’s life and improve their overall health.