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Smoking and Coronary Artery Disease


Quitting smoking is probably the most important step you can take to decrease your chance of coronary artery disease and a heart attack. Smoking raises your risk of getting coronary artery disease and dying early from it.

Carbon monoxide, nicotine, and other substances in tobacco smoke can promote atherosclerosis and trigger symptoms of coronary artery disease.


  • Causes the platelets in your blood to clump together easily by making your blood cells more "sticky" and more likely to form clots. Clumping platelets can then block your coronary arteries and cause a heart attack.
  • Can cause spasms in your coronary arteries, which can reduce the blood flow to your heart in a way similar to that of atherosclerosis.
  • Can trigger irregular heartbeats (arrhythmias).
  • Lowers "good" cholesterol (high-density lipoprotein, or HDL). Cholesterol-carrying lipoproteins also more easily enter the walls of your arteries, where they can develop into a hard plaque and atherosclerosis.
  • Reduces the amount of oxygen that can be carried by red blood cells in the bloodstream.

Smoking also affects those around you. Second-hand smoke increases other people's risk of coronary artery disease.

Benefits of quitting

Quitting smoking is one of the best things you can do if you have coronary artery disease. Your risk of dying from a heart attack or stroke will start to go down after you quit. In time, your risk may be about the same as that of someone who has never smoked.

If you've had angioplasty or bypass surgery to improve blood flow to your coronary arteries, those arteries will be less likely to get narrowed again if you quit smoking.

You will also feel better after you quit smoking. Your angina symptoms may get better. You will have more energy and will breathe easier.

How to quit

Having a plan and using medicines can help you quit. A quit plan helps you plan ahead. Before you quit, you identify the things that are likely to trigger tobacco use and how you'll manage them. You also think about what you need for support. Your doctor can suggest medicines to try.


Current as of: September 7, 2022

Author: Healthwise Staff
Medical Review:
Rakesh K. Pai MD, FACC - Cardiology, Electrophysiology
Martin J. Gabica MD - Family Medicine
Adam Husney MD - Family Medicine
E. Gregory Thompson MD - Internal Medicine