Wednesday, November 23, 2011

Smoking Linked to Vascular Diseases

While lung cancer is the obvious threat, tobacco use also damages arteries



The American Cancer Society’s (ACS) annual Great American Smokeout this month marked a commitment for millions of smokers to kick the habit for one day.  The hope behind the Smokeout, which is in its 36th year, is to make one day turn into a lifetime pledge.  According to the ACS, tobacco use accounts for roughly 1 in 5 deaths in the U.S (over 440,000 premature deaths every year), and the Centers for Disease Control and Prevention (CDC) says over 8.6 million people live with a serious illness caused by smoking.  While lung cancer is the most well-known disease, smokers are at greater risks than nonsmokers at getting vascular diseases, heart disease and strokes.

Locally, the city of Boston stepped up its efforts this year to not only provide education regarding the dangers of smoking, but create more smoke-free areas and give those who want to quit the tools to succeed.  Boston Mayor Thomas M. Menino recently announced one of the ways the city is getting involved by introducing the Boston Tobacco-Free Hospitals Initiative.  Massachusetts General Hospital is joining the Initiative with nine other Boston hospitals in implementing campus-wide smoking bans, giving smoking cessation products to employees and improving screening and cessation resources for patients.  Information on free nicotine therapy can be found below the Q&A.

If the numbers about smoking don’t hit close to home, this CDC statistic may help.  Smokers on average die approximately 14 years earlier than nonsmokers.  Michael R. Jaff, DO, medical director of the Mass General Vascular Center, answers questions about the affects smoking has on patients who suffer from vascular diseases.

What vascular diseases are people more apt to get when they smoke?

Any artery is affected -- coronary, carotid, leg, and aortic aneurysms.  For example, cigarette smoking is one of the two most important risk factors for the development of peripheral artery disease (PAD), which is artery blockage in the leg that can cause pain while doing physical activities.  If PAD is left untreated, it can lead to heart attacks, stroke, sometimes resulting in amputation or even death.  (More information about peripheral vascular diseases)


What is the connection between smoking and vascular diseases?

Tobacco results in damage to the inner lining of the artery, called the endothelium. Contents of tobacco smoke cause this toxicity to the artery.  The endothelium becomes “dysfunctional”, and causes stiffness of the artery, calcium deposits in the artery, and ultimately plaque.


What is your advice for smokers?  Do they need to look beyond just having a greater risk of getting cancer?

We always advise patients that although cancer is a big concern, artery disease is a much more common killer of Americans. Cardiovascular diseases represent the single greatest killer of US adults.  Tobacco use also causes chronic lung diseases (emphysema, chronic bronchitis).


Do you have advice for a patient who says quitting smoking at his or her old age won't make a difference in their health and wellness?

This is just not true. After stopping smoking for 5 years, patients have a marked reduction in smoking-related diseases.  The most important part of the process is to actively choose to stop smoking and set a date. It is critical to choose a stop smoking date, and now is the best time.  


Beyond smoking, what is the role of exercise in the treatment of vascular diseases?  Is a small amount of exercise better than little to no activity?

Particularly in patients with leg artery disease, exercise has shown a significant improvement in walking distance compared to even invasive procedures. (CLEVER Trial, presented at the American Heart Association this month in Orlando (  Participating in low-to-moderate intensity activities, such as walking, gardening, dancing, cycling, swimming, and many other physical activities go a long way in improving blood circulation throughout the body, helping to manage high blood pressure, high cholesterol, diabetes, and reducing stress.



Free Two-Week Supply of Nicotine Patches

The Boston Public Heath Commission (BPHC) is offering a free two-week supply of nicotine patches for those who smoke 10 or more cigarettes per day and live or work in Boston.  Call 1-800-QUIT-NOW for more information.  This patch giveaway ends Feb. 28, 2012


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