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Researchers say quitting smoking lowers your risk for cardiovascular health problems, but not as much as never smoking. Getty Images
  • Researchers say you can see significant benefits to your heart health after five years of quitting smoking.
  • The health benefits to quitting smoking are still not as significant as if you never smoked.
  • Researchers say smoking’s damage to the lungs is well publicized, but the damage to the heart is less known.

If you’re a heavy smoker and quit now, within five years you could see a significant reduction in your risk for cardiovascular disease.

But you’ll still have more risk for cardiovascular disease than someone who never smoked.

That’s according to a new study published in JAMA.

The retrospective analysis looked at 8,770 people, including 2,371 who had smoked 20 or more “pack years.” That’s the same as smoking a pack of cigarettes a day for 20 years.

The average follow-up time was 26 years. In that time, 2,435 of the participants had a first cardiovascular event, such as heart attack, stroke, heart failure, or cardiovascular death.

Heavy smokers accounted for 1,095 of those events.

Compared with current smokers, quitting within five years was associated with a lower rate of cardiovascular events.

For heavy smokers, there’s still an increased cardiovascular risk for 10 to 15 years or more.

The study authors note the investigation included mostly white people of European ancestry. They also lacked information on secondhand tobacco smoke exposure or use of other types of tobacco among the study participants.

Dr. Srilakshmi Vallabhaneni is a senior cardiology fellow at St. Luke’s University Health Network in Bethlehem, Pennsylvania.

“Smoking is a well-known risk factor for lung problems,” she told Healthline. “The heart hasn’t been highlighted as much. It was a small sample size, but large enough to answer the question about cardiovascular risks five years after quitting smoking.”

Warning signs of cardiovascular problems include shortness of breath, chest pain, and leg pain when you walk, she explains.

Although more data is needed, Vallabhaneni says cardiovascular risk for pipe and cigar smokers is higher than for nonsmokers, although not as high as for heavy cigarette smokers.

She also notes that smoking marijuana can affect the heart rhythm and increase the risk of heart attack.

While the new study focused on heavy cigarette smokers, Dr. Robert Greenfield cautions that any amount of smoking is a problem.

Greenfield is a double board-certified cardiologist and lipidologist and medical director of noninvasive cardiology and cardiac rehabilitation at MemorialCare Heart & Vascular Institute at Orange Coast Medical Center in California.

“Every time you put a cigarette in your mouth, whether you inhale or not, you’re sucking in carbon monoxide,” Greenfield told Healthline.

“It gets into the bloodstream, where it displaces oxygen in red blood cells. Carbon monoxide damages the lining of arteries and affects cholesterol circulation, creating more plaque,” he said.

“If someone is smoking, they should assume a negative impact on the body. And if you’re a nonsmoker because you quit last year, you may be underestimating your risk,” Greenfield said.

He notes that cardiovascular disease is complex and involves other risk factors, including diet, stress, and family history.

The study shows that if you’ve been a heavy smoker, you have to be even more vigilant about staying healthy, according to Greenfield.

“The sooner you can stop smoking, the better. But it’s not as simple as stopping and in five years you’re OK. The cardiology community should be looking at ex-smokers differently and be more diligent in talking to patients,” he said.

Vallabhaneni says that understanding the negative effects of smoking can give smokers more motivation to quit.

In addition to smoking cessation programs and medications, counseling by doctors is crucial.

Quitting cold turkey is hard, so she advises heavy smokers to create smaller goals.

“If you smoke 10 cigarettes a day, maybe cut down to eight, then six. Cutting down a little every few weeks seems to work really well. And patients can relapse over time, so we need to reinforce that when they see their primary care physician or cardiologist if they have a heart problem,” she said.

Vallabhaneni recommends that smokers and ex-smokers take care to monitor and manage high blood pressure, high cholesterol, and diabetes.

“Also stay active and exercise. We recommend 30 minutes a day, five days a week, even if it’s just walking. Do what you like to do, but stay active,” she said.

“Public policy is also important. Smoking restrictions in public places and even at home can help reinforce this and are very effective in reducing smoking,” Vallabhaneni added.

The Centers for Disease Control and Prevention offers more information on how to quit smoking.

“The good news is that we’re all living longer now, but a lot of people are not living healthier,” Greenfield said. “The value of this study is that it shows that the things we do to our body now stay with us. It doesn’t always go away because we stop smoking.”

Greenfield advises young people to think of what they do now as an investment in their future.

“Smoking changes the body,” he said. “We can paint a picture of what could happen. I wish I could take young smokers into the intensive care unit at the hospital to show them people on ventilators. We’ve done a good job with some of the scary advertising for not smoking.”

Greenfield explains that medicines prescribed to treat high blood pressure and high cholesterol can be less effective for smokers.

“Lifestyle is the best medicine we can prescribe. We try to prevent risk factors rather than treat once there’s a problem. We have to sit down with young people and have a conversation. It’s the right thing to do,” Greenfield said.