Smoking

Smoking is a major modifiable risk factor for cardiovascular disease, contributing to 11% of CVD deaths in the UK. In this article, you’ll learn more about how smoking contributes to CVD and how to lower your risk.

In the UK, 1 in 8 adults smoke. Cigarette smoke contains many harmful chemicals, including carbon monoxide, tar and nicotine.¹ Carbon monoxide stops red blood cells from carrying oxygen, so the heart has to work much harder to deliver enough oxygen around the body. Tar damages the lungs and accelerates atherosclerosis. Nicotine increases heart rate and blood pressure, which are known to increase the risk of many cardiovascular diseases. Smoking has also been shown to increase inflammation, stimulate platelets, damage blood vessel walls, and decrease levels of HDL. Smoking is also linked to cancers and many other health conditions.

What can you do to lower your risk?

In the UK, there are many initiatives to try and reduce the health burden of both active and passive smoking, such as indoor smoking bans and increasing the age to purchase cigarettes. Unlike many risk factors, the risk from smoking is one you can stop completely.

If you stop smoking, your risk of a heart attack decreases and is half that of a smoker after 1 year.

Lots of support is available in the UK to help people stop smoking, including support groups and prescription nicotine replacement products.

Whilst the NHS does not currently prescribe e-cigarettes as they are not “medicines”, many smokers are switching to e-cigarettes. E-cigarettes have helped lots of people quit; however, little is known about their long-term use. E-cigarettes don’t contain many of the harmful chemicals found in cigarettes but do contain various additives and chemicals in addition to nicotine, and some concerns over their safety are starting to emerge.

In 2023, the World Health Organization² announced a call-to-action to prevent uptake of e-cigarettes on the basis that they are harmful to health. This highlights that e-cigarettes may not be the perfect solution to the smoking problem. The BHF explores alternatives to cigarette smoking and also offers guidance for those wishing to quit.

You also can download the Week 4 supplement, which contains additional images and descriptions to help you understand the topics covered in this step.

All statistics from British Heart Foundation unless cited otherwise. British Heart Foundation (2025) Heart & Circulatory Disease Statistics, 2025 Compendium. [Internet]. London: British Heart Foundation; 2025 [cited 2025 Oct 9]. 183p. Available from: https://www.bhf.org.uk/what-we-do/our-research/heart-statistics/heart-statistics-publications/cardiovascular-disease-statistics-2025