Ask an Expert

Quit Smoking

Find answers to questions about how smoking affects our health and how to kick the habit.

  • Is there a "safe" level of exposure to secondhand smoke?
  • No, there is no known safe level of exposure to secondhand smoke. Breathing in any amount of secondhand smoke can be dangerous, which is why many states have passed laws that prohibit smoking in public places, such as workplaces, restaurants and bars.
  • What is secondhand smoke?
  • Secondhand smoke, also referred to as environmental tobacco smoke, includes the smoke that comes from the lighted end of a tobacco product (sidestream smoke) and the smoke exhaled by a smoker (mainstream smoke). Similar to tobacco use, secondhand smoke is a “known human carcinogen,” which means that it’s known to cause cancer.
  • What are the health consequences of secondhand smoke?
  • Exposure to secondhand smoke can have lasting health effects and research shows that there is no safe level of secondhand smoke. Exposure to secondhand smoke can cause lung cancer, heart disease, asthma and many other serious health conditions.
  • How can you help someone quit smoking?
  • Family and friends are an important source of support and motivation for a person who is trying to quit smoking. Before offering help, ask if it's OK to help, and then ask what you can do—don't assume that the person wants your help or that you know the best way to help. But if a person asks for your support, there are many things you may be able to do such as sharing your smoking history, providing emotional support, helping with avoiding triggers, helping someone who relapses, and suggesting resources. For more information about helping someone quit, read this guide.
  • What is smokeless tobacco?
  • Smokeless tobacco is tobacco that is not burned, and includes snuff, chewing and dipping tobacco. Smokeless tobacco contains cancer-causing agents, and users have an increased risk of developing oral cancer, esophageal cancer and pancreatic cancer. Smokeless tobacco is no safer than cigarettes and use of these products is strongly discouraged. For more information or help quitting, see our resource page.
  • Is smokeless tobacco addictive?
  • Yes. Smokeless tobacco contains nicotine, which is addictive. Cigarettes and smokeless tobacco contain similar levels of nicotine, and are both known to cause cancer. For more information or help quitting, see our resource page.
  • What is the Tobacco Control Act?
  • The Tobacco Control Act was passed in 2009 to give the U.S. Food and Drug Administration (FDA) authority to regulate the manufacture, distribution and marketing of tobacco products to protect the public’s health. In other words, when the FDA considers whether to approve new tobacco products, they must decide whether it would cause more harm than good on a population level. This new authority will help prevent tobacco companies from selling and marketing products that might mislead Americans or counteract anti-smoking efforts that have long been in place.
  • How can I encourage a loved one to quit smoking?
  • Carbon monoxide, nicotine and other substances in tobacco smoke can lead to a build-up of plaque and fatty substances in the arteries and trigger symptoms of coronary artery disease. It’s important that they know the health risks to themselves and others. Offer encouragement and help them find resources and cessation programs to assist them in quitting the habit.

  • How dangerous is smoking?
  • Tobacco use remains the single most preventable cause of death, especially as it relates to heart disease.

  • What if I have tried to learn more about my health but still have trouble understanding?
  • Patients who have trouble understanding their health conditions should ask for help from their health care team, whether it's a doctor, nurse or counselor. Health care providers can help point patients to a variety of resources that can cater to individual needs.
  • What complications are smokers most at risk for following surgery?

  • Smoking significantly increases risk for postoperative complications, such as pneumonia, wound infections and pulmonary complications, including heart attack and stroke. These complications can be extremely serious and often fatal.
  • Why are female smokers at greater risk for heart disease than men?

  • There are many possible explanations for increased cardiovascular risk in female smokers, one of which is biology. It is possible that women are more sensitive than men to the harmful effects of smoking, making them more susceptible to adverse health effects such as heart disease. However, more research is needed to identify the exact causes of increased cardiovascular risk in female smokers.
  • Where can I find nicotine patches?

  • Nicotine patches can be purchased over the counter at most drug stores. However, it is important that you check with your doctor before using the patch, especially if you take other medications. Pregnant women should not use the patch unless advised to do so by their doctor.
  • Why does smoking increase risk for heart disease?

  • Smoking causes plaque build up in the arteries, which reduces the flow of blood to the heart and body, increasing blood pressure. Over time, this can put an extreme strain on the heart and other parts of the body.
  • Why is it so hard to quit smoking?

  • According to, smokers face both a physical addiction and a psychological addiction. The physical addiction comes from the way nicotine acts on the brain cells to create a feeling of pleasure and alertness. Unfortunately, your body clears away the nicotine in about 30 minutes, leaving you tired, jittery—and craving another cigarette.

    The psychological addiction comes from both habits that are hard to break and the positive feelings some people associate with smoking. For example, if you smoke a cigarette every morning when you first wake up, your brain comes to associate waking up with smoking, and you will automatically crave a cigarette first thing in the morning. This habit is made even stronger by the physical pleasure you feel when nicotine hits your brain. The other part of psychological addiction is the way smoking makes some people feel about themselves: cool, hip, relaxed. Getting through certain social situations without a cigarette can be difficult.
  • When is the best time to quit smoking before surgery?

  • Although results from the study above did not show any risk in quitting smoking close to the date of surgery, the earlier a patient can stop smoking before surgery, the better. Research has shown significant benefits to quitting smoking before surgery, but these benefits have been found in patients that quit early on, further from their surgery date.
  • What smoking cessation aids exist to help smokers quit?

  • A variety of tools exist to help smokers quit. Aside from quitting cold turkey without the use of aids, adults can be prescribed smoking cessation drugs that help to fight nicotine withdrawal and tobacco cravings. There are also various types of nicotine replacement therapy, including patches, inhalers, lozenges, gum and nasal spray that can help wean smokers off of cigarettes.
  • Are there any negative side effects of cytisine?

  • In the study published in the New England Journal of Medicine, researchers found that increased risk for gastrointestinal adverse events might be associated with the drug. However, further research is needed to better assess this relationship.
  • After quitting smoking, how long until my risk for peripheral artery disease equals that of a non-smoker?
  • In the study performed by Harvard Medical School, women having quit smoking for 20 years still had higher risk than women who never were smokers. However, compared with women who still smoke, their risk was significantly lower.
  • Are the health effects of smoking irreversible?

  • Absolutely not. Smokers experience many benefits by quitting, some of which begin just minutes after stopping smoking. Twenty minutes after quitting, blood pressure and heart rate will drop, and the benefits continue to improve over time. One year after quitting, risk of heart disease will be half that of a smoker; within years, risk for stroke, heart disease and other health conditions can equal that of a non-smoker.
  • How should I prepare for "quit day?"

  • Getting ready to quit smoking is just as important as the actual "quit day." Here are some steps you can take:

    • Talk to your doctor not only about stop-smoking medications, but also about how quitting smoking may affect other medications you’re taking.
    • Arrange for a support system to help you at home, at work and in your social life.
    • Keep a record of when you smoke and why. This will help you identify triggers to smoking. Once you know your triggers, you can plan how to cope with them without smoking.

    Make quit day a big deal by starting fresh in lots of ways:

    • Throw away all of your cigarettes. Check all of your hiding places to make sure you get rid of every last one.
    • Get rid of your ashtrays.
    • Clean your house and wash your clothes to remove the cigarette smell.
    • Cut down on your caffeine intake starting several days before quit day. Nicotine makes your body metabolize caffeine more quickly. Once you stop smoking, you’ll feel jittery and nervous if you keep drinking the same amount of caffeine.
    • Drink lots of water.
    • Get some exercise. You’ll feel better and it will keep your mind off smoking.
  • How does the nicotine patch work?

  • The nicotine patch is a square bandage that provides a steady, controlled dose of nicotine to the body throughout the day. This reduces the effects of nicotine withdrawal, helping reduce cravings for cigarettes. Over time, the strength of the patch will be reduced so that individuals can gradually wean themselves off of nicotine.
  • How does cytisine work to aid smoking cessation?

  • Cytisine is a type of drug that is a nicotine substitute made from a type of seeds, called laburnum seeds. By imitating the effects that smokers get from nicotine, taking cytisine can help cut cravings and wean smokers off of cigarettes.
  • How does smoking impact my risk of developing atherosclerosis?

Ask an Expert

Please note that every question submitted will not receive a direct response from a Cardiologist. However, we will follow-up with suggested ways to find appropriate information related to your question. Please do not use your last name or any other confidential information in your question.

Meet our Expert

Your questions are answered by more than two dozen members of the American College of Cardiology who volunteer their time with CardioSmart.

Learn more about our volunteers