How Smoking Damages Your Heart and Blood Vessels
Key takeaways
Health Canada says smoking can cause heart attacks, angina, strokes and blocked arteries in the legs, and attributed 12,710 heart disease deaths in Canada to smoking in 2012. Heart attack risk starts to drop within 24 hours of quitting, and added coronary heart disease risk is half that of a smoker after one year.
This page is general information from public health sources, not medical advice. If you think you are having a heart attack, call 9-1-1 or your local emergency number.
What does smoking do to the heart?
Health Canada’s page on smoking and your body says smoking can cause heart attacks and angina, which it groups as coronary heart diseases. It can also block arteries in the legs, a condition called peripheral vascular disease, and cause strokes. Cardiovascular disease, in Health Canada’s wording, covers the heart, the blood vessels of the heart and the blood vessel system throughout the body and brain.
The mechanism behind a heart attack is spelled out by HealthLinkBC: part of the heart muscle does not get enough blood and oxygen, and the most common cause is a coronary artery blocked by a blood clot. Health Canada names smoking as a cause of coronary heart disease; the HealthLinkBC page on heart attacks does not discuss smoking itself.
How many heart disease deaths are linked to smoking in Canada?
Health Canada reports that smoking accounted for 12,710 heart disease deaths in 2012, and second-hand smoke for another 612. For scale, the same page puts smoking-related cancer deaths that year at 21,366 and respiratory disease deaths at 9,937. These are the latest cause-by-cause figures on the page, so treat them as a snapshot from 2012. More recent overall estimates on the page are about 48,000 tobacco deaths a year based on 2017 data and about 46,000 in 2020.
The page also says smoking can cut life expectancy by about 10 years. Quitting by age 40 could reduce that risk by about 90%, and quitting at 60 by about 40%.
How quickly does heart risk fall after you quit?
Health Canada’s quitting timeline gives these milestones:
| After quitting | What changes |
|---|---|
| 20 minutes | Blood pressure drops toward pre-smoking levels |
| 24 hours | Heart attack risk starts to drop |
| 1 year | Added coronary heart disease risk is half that of a smoker |
| 5 years | Stroke risk matches a non-smoker’s |
| 15 years | Coronary heart disease risk is similar to a non-smoker’s |
These are general milestones from Health Canada, not predictions for any one person. The full recovery timeline covers lungs, taste and other changes.
Can I use quit medications with a heart condition?
Often yes, but talk to a clinician first. The BC clinical guideline on tobacco use disorder says nicotine replacement is safe in stable cardiovascular disease and that caution is needed in unstable disease: angina, arrhythmias, or a heart attack within the past two weeks. Comparing options and what each province covers is on the quit smoking medications page.
Where does the heart fit with other smoking harms?
Heart disease sits alongside cancer and lung disease as the main ways smoking shortens life. The side effects of cigarettes page covers the range, smoker’s lungs covers airway damage, and smoking statistics for Canada shows how many people still smoke.
Health information is general and educational. It does not replace advice from a doctor, pharmacist or nurse. Read the full disclaimer.
Frequently asked questions
How does smoking cause a heart attack?
HealthLinkBC says a heart attack happens when part of the heart muscle does not get enough blood and oxygen, most commonly because a coronary artery is blocked by a blood clot. Health Canada lists heart attacks and angina among the coronary heart diseases that smoking can cause.
How soon does heart risk drop after quitting smoking?
Health Canada says heart attack risk starts to drop within 24 hours. After one year the added coronary heart disease risk is half that of someone who smokes, and after 15 years it is similar to a non-smoker's.
Is nicotine replacement safe if I have heart disease?
The BC tobacco use disorder guideline says nicotine replacement is safe in stable cardiovascular disease and calls for caution in unstable disease, such as angina, arrhythmias or a heart attack within the past two weeks. Ask your doctor or pharmacist before starting.
Sources
- Smoking and your body — Health Canada. Accessed October 27, 2026.
- Tobacco and premature death — Health Canada. Accessed October 27, 2026.
- Quit smoking: decide to quit — Health Canada. Accessed October 27, 2026.
- Heart Attack — HealthLinkBC (Government of British Columbia). Accessed October 27, 2026.
- Tobacco Use Disorder (TUD) — Government of British Columbia (BC Guidelines). Accessed October 27, 2026.