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When you consider the health hazards of smoking, lung disease and cancer likely come to mind.

But the truth is that smoking impacts more than just your lung health. It can increase your risk for heart disease and stroke, high cholesterol, and other heart health issues.

In fact, people who smoke are two to four times more likely to develop heart disease than people who don’t, according to the American Heart Association. And your risk for stroke doubles if you smoke cigarettes.

Much of this increased risk stems from the fact that cigarette smoke contains thousands of chemicals that can damage your blood vessels and increase your cholesterol levels.

This can make it harder for your body to remove unhealthy cholesterol from your blood, allowing cholesterol to build up in your arteries.

This article will explain how smoking affects your cholesterol levels and what you can do to improve your heart health if you smoke.

Cholesterol is a waxy, fat-like substance in your blood that’s produced naturally by your liver.

Cholesterol plays a role in cell creation, hormone production, and food digestion. Your body makes all the cholesterol it needs. However, cholesterol is also found in some foods, and many people get more cholesterol than they need from their diet.

A high-fat diet can increase your risk for high cholesterol, but other factors play a part in your cholesterol levels as well, including your genes and whether you smoke.

There are two types of cholesterol: low-density lipoprotein (LDL) and high-density lipoprotein (HDL).

LDL, also called the “bad” cholesterol, can create a fatty buildup of a substance called plaque on the inside of your arteries. This can narrow your arteries and increase your risk for:

According to the National Institutes of Health (NIH), a healthy level of LDL cholesterol for people of any age is a reading below 100 milligrams per deciliter (mg/dL).

HDL, known as the “healthy” cholesterol, can remove LDL and transport it to the liver where it’s flushed out of your body.

Unlike LDL cholesterol, you want your HDL to be a higher number. A healthy level of HDL is above 40 mg/dL for men and above 50 mg/dL for women.

Ideally, your total combined cholesterol should be below 200 mg/dL.

The only way to know your cholesterol numbers is with a lipid profile blood test. Your healthcare professional can order a test. If you have a history of high blood cholesterol or risk factors for it, a blood test will likely be part of your regular appointments.

Smoking has a significant impact on your body. It can damage your lungs and increase your risk of:

Beyond the impact on your lungs, smoking can also impact your cardiovascular health.

Your lungs can absorb vapors released in cigarette smoke. These substances have been shown to:

  • lower HDL levels
  • increase LDL levels
  • make blood thicker and stickier, and more likely to clot
  • damage the cells that line blood vessels and arteries
  • cause thickening and narrowing of blood vessels

Additionally, research has found that a compound called acrolein, which is found in cigarette smoke, goes a step further to impact your body’s cholesterol levels.

This highly reactive compound prevents the HDL in your blood from transporting the LDL out of your arteries and to your liver.

This means that smoking not only increases LDL accumulation, but it also impairs the ability of HDL cholesterol to reverse the damage caused by LDL.

The impact smoking has on your body doesn’t stop with high cholesterol levels. Smoking can increase your risk for heart attack and stroke.

Smoking can raise your LDL cholesterol levels and lower your HDL cholesterol levels. Over time, this can lead to inflammation in your blood vessels and arteries, and plaque can build up in your arteries.

This plaque can harden and break off, which can lead to blood clots and strokes.

When you have plaque in your arteries, your heart has a harder time pumping blood through your body. That makes your heart work harder and decreases blood flow to all areas of your body.

These circumstances can result in a condition called coronary heart disease, or coronary artery disease. Coronary heart disease is the leading cause of death in the United States.

Smoking and high cholesterol are not the only risk factors for heart disease. Other risk factors include:

  • family history
  • obesity
  • age
  • diet

However, smoking is one of the risk factors that you can control. In turn, quitting smoking can help improve cholesterol levels and lower your risk for heart disease, heart attack, and stroke.

Yes, quitting smoking can reverse heart damage. In fact, it can do so quickly.

According to the American Heart Association, one-third of deaths from coronary heart disease each year are due to smoking and secondhand smoke. On average, people who smoke die more than 10 years earlier than people who don’t smoke.

But quitting can positively impact your health within a short time frame. With time, you can nearly eliminate the damage that smoking caused to your blood vessels and heart:

  • After 1 year of being smoke-free, your risk of heart disease and heart attacks will be halved.
  • After 15 years, your risk for heart disease and heart attacks will be similar to someone who has never smoked.
  • One study found that levels of HDL in former smokers return to levels equal to that of nonsmokers within 1 year of quitting.

Quitting smoking has other health benefits beyond the good it does for your cholesterol and heart health.

For example, the nerve endings in your nose and mouth begin to grow back within 48 hours of your last cigarette. This will help restore your sense of smell and taste, which is damaged by smoking.

You’ll have more oxygen in your blood, which will translate to more energy for your cells and tissues to use. The improved oxygen levels can also help boost immunity and lower inflammation, so you’re better able to fight off colds, viruses, and other illnesses.

Quitting smoking lowers your risk of several cancers, too, including:

  • lung cancer
  • brain cancer
  • bladder cancer
  • throat cancer

Quitting tobacco may not be easy. Smoking is an addiction on two fronts: Nicotine causes a chemical addiction, and smoking cigarettes is a behavior addiction.

But you can overcome both of these. Indeed, quitting smoking is key to managing your risk for high cholesterol, heart disease, and many other health issues. So even if it takes a few tries, it’s important to keep trying. You have a lot to gain from being tobacco-free.

If you’re new to the challenge of smoking cessation, or if you need new resources, consider these options:

  • Medications. Prescription medications like varenicline (Chantrix) and bupropion (Zyban) alter the chemicals in your brain to ease cravings and reduce symptoms of nicotine withdrawal.
  • Smoking cessation aids. Skin patches, gums, lozenges, and nasal sprays can all deliver nicotine without the toxic tars and gases found in cigarette smoke. These can be used to help ease withdrawal symptoms as you reduce dependency.

You don’t have to quit smoking by yourself. In fact, forming a support team can be a strategic way to increase your chances of successfully quitting. You may want to consider partnering with a:

  • Medical professional. Your doctor or healthcare professional can discuss options for quitting that may require a prescription. They can also help you address any issues that arise with quitting and withdrawals.
  • Smoking cessation specialist. Some healthcare organizations employ smoking cessation specialists who organize support groups and offer a variety of resources to those looking to quit. If you’re unaware of specialists in your area, ask your doctor for a referral.
  • Support group. As with any addiction, quitting smoking can be difficult to understand for people who’ve never been through it. A support group of former smokers and people trying to quit can be a good resource for encouragement, ideas, and resources.

Smoking doesn’t only cause damage to your lungs. It can have a significant impact on your heart health, too.

Smoking can elevate the LDL, or “bad,” cholesterol in your blood and decrease HDL, or “healthy,” cholesterol.

In turn, high cholesterol levels in your blood can lead to a buildup of plaque in your arteries, causing them to become narrower. This increases the risk for heart disease, heart attack, and stroke.

Smoking and high cholesterol are an especially dangerous combination for your heart. But quitting smoking can lower your cholesterol levels and improve your overall health in many important ways.