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Review
. 2020 Jul;12(7):3866-3876.
doi: 10.21037/jtd.2020.02.47.

Cardiovascular risk of smoking and benefits of smoking cessation

Giuseppina Gallucci  1 , Alfredo Tartarone  2 , Rosa Lerose  3 , Anna Vittoria Lalinga  4 , Alba Maria Capobianco  2
Affiliations
Review

Cardiovascular risk of smoking and benefits of smoking cessation

Giuseppina Gallucci et al. J Thorac Dis. 2020 Jul.

Abstract

Smoking increases mortality from all causes and has a crucial role in atherosclerotic cardiovascular disease (ASCVD). Active smoking and secondhand smoke exposure determine more than 30% of coronary heart disease (CHD) mortality. The exact mechanisms of cardiovascular damages are not well known, but the detrimental effect of smoking on endothelial function has long been recognized. Smoking elicits oxidative processes, negatively affects platelet function, fibrinolysis, inflammation and vasomotor function; all these proatherogenic effects double the 10-year risk of fatal events in smokers compared to non smokers. An intriguing issue about smoking is the vulnerability of female gender. The mortality from cardiovascular diseases (CVDs) is higher in female than male smokers and female smokers show a 25% higher risk of developing CHD than men with the same exposure to tobacco smoke. This female vulnerability seems to be related to genes involved in thrombin signaling. The effects of smoking cessation have also been extensively studied. Cessation at an early age (40 years) has an impressive 90% reduction in the excess risk of death. In this review we report recent data about the causal link between smoking and CVDs and about the benefits of smoking cessation.

Keywords: Cardiovascular diseases (CVDs); secondhand smoke; tobacco smoking.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/jtd.2020.02.47). The series “Improving Outcomes in Lung Cancer Through Early Diagnosis and Smoking Cessation” was commissioned by the editorial office without any funding or sponsorship. AT served as the unpaid Guest Editor of the series and serves as an unpaid editorial board member of Journal of Thoracic Disease from Aug 2019 to Jul 2021. The authors have no other conflicts of interest to declare.

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