VIDEO
How smoking causes High Blood Pressure
Non-pharmacological treatment
Smoking
I am a heavy smoker and have been told to stop. What are the benefits of stop smoking?
Smoking is strongly associated with increased overall heart attack and stroke risk, cancers and respiratory disease, and has a strong relationship with overall mortality rates. For example, middle-aged smokers are three times more likely to die early than their non-smoking counterparts.
There is also a strong dose response relationship: the more cigarettes you smoke, the greater your risk of cancer, cardiovascular problems, and death.
For these reasons, quitting smoking is a good idea. There are several smoking-quitting strategies that are known to be effective. Several studies have shown that counseling and nicotine replacement (in the form of a patch, gum or nasal spray) are effective in helping people to quit smoking.
In people who stop smoking, risk of cardiovascular problems, cancer and death falls substantially. It appears that for people who are ex-smokers, their risk falls gradually to a risk level between lifelong smokers and people who have never smoked in the past.
There is also a newer and effective drug available to people in whom nicotine replacement has not worked – buproprion (Zyban), a form of antidepressant.
Our advice is that quitting smoking is probably the most important thing you can do to reduce your overall risk of heart attack or stroke whether you have hypertension or not.
Community counseling services offered in conjunction with nicotine replacement or buproprion treatment are available on the NHS. You should ask your doctor to arrange referral to these support services.
So will stopping smoking reduce my BP as well as my risk of heart attack or stroke?
No, but for most people with high BP who smoke, stopping smoking reduces the risk of coronary heart attacks more than does reducing BP itself, particularly in younger people; it also greatly reduces the risk of obstructed leg arteries, cancer of the lung, throat, larynx, pancreas and bladder, stops further deterioration of chronic bronchitis and airways obstruction, and somewhat reduces your risk of stroke. All this alone makes stopping smoking very worthwhile.
If I can’t stop smoking, will that make treatment for high BP ineffective?
Generally, no. Benefit from treatment is greatest in people at highest risk. As people who continue smoking are at much higher risk than those who stop, or never started, they actually benefit more from treatment. The greatest probable health gains are from both stopping smoking and reducing BP.
Which is most important, stopping smoking or controlling high BP?
Smoking is a bigger and more completely reversible risk factor than high BP, except in a small minority of people with very severe high BP, usually with diastolic pressures well over 120 mmHg.
Smoking is not a cause of high BP, but it greatly increases its consequent risks. If you have high BP already, your risk of a heart attack is increased three times by smoking up to about 50 years of age, and doubled after that age. Heart attacks in people under 45 happen almost entirely in smokers.
Smoking is a very powerful risk factor in its own right, not only for coronary heart disease and stroke, but also for cancer as mentioned above, and for asthma and other obstructive lung diseases. Unlike all other risk factors, it also affects your family and friends, because they are subjected to passive smoking, and the example you set to your children is poor.
I quite like smoking cigars or a pipe. Are these safer substitutes for cigarettes?
Generally no. People who have smoked cigars or a pipe all their lives, and have never smoked cigarettes, rarely inhale tobacco smoke and are therefore at lower risk of all the consequences of smoking, other than cancer of the mouth and throat, but very few such people exist.
Virtually all cigarette smokers inhale, whether consciously or unconsciously. If they change to pipe or cigar smoking, they continue to inhale (often unconsciously and with furious denials, refuted by tests for carbon monoxide levels).
Their loads of both nicotine and carbon monoxide (the main reasons why smoking promotes heart disease) and of tobacco tar (the main reason why smoking promotes lung cancer) are even greater in cigar and most pipe smokers, than in cigarette smokers.
