“Which pocket in your purse do you carry your cigarettes?”

The patient pulled a pack from her coat and handed them me. I tossed them in the trash.

It was a bold move, but she said she understood the symbolic gesture and decided to quit smoking. It worked for this patient but everyone is different.

Quitting is hard. The facts, however, are sobering. Every year there are 800,000 cardiovascular deaths, which include heart attacks and strokes, and 20 percent of those are linked to smoking.

How smoking damages the heart

  • Smoking makes your blood more prone to clotting, which means smokers are at higher risk for heart attacks and strokes. The toxins in smoke contaminate the blood, which causes direct damage to the heart, the blood vessels and the lungs. This can lead to coronary artery disease or blockages, increases the risk of blood clots in arteries in the heart as well as the brain.
  • Smoking can cause hypertension, which can damage the lining of the arteries and lead to peripheral artery disease. Smoking is strongly linked to Buerger’s disease, an inflammation in the arteries of the legs, which can lead to blockage. It can also lead to leg pain while walking. Buerger’s disease can be reversed if the patient stops smoking.
  • Smoking increases the risk for pulmonary embolus, which is caused by a blood clot in the leg that travels up to the lung and lodges in an artery. Women who smoke and take oral contraceptives are at greater risk.
  • Second-hand smoke increases the risk of coronary disease by 20 to 30 percent compared to those people not exposed to second-hand smoke. Smokers harm themselves and those around them in the same room or automobile.

The benefits of quitting

  • Quitting smoking benefits the heart as soon as 20 minutes after the last cigarette. The heart rate drops, the vessels start to relax.
  • 12 hours after quitting, carbon monoxide levels drop.
  • 4 years after quitting, the risk of stroke and cardiovascular disease drops to the same level as a lifetime nonsmoker. However, the risk of developing lung cancer persists.

My best tip for quitting is this: I often advise my patients about the success of tapering by 1-2 cigarettes per day per week to gradually cut the dependence on nicotine over time. For a half a pack a day smoker, they’ll cut to 9 cigarettes per day for a week then 8 cigarettes per day and so on until complete cessation.

If you smoke, quitting is one of the best things you can do for your health.

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