07 Risk factor: Tobacco CYAN MAGENTA YELLOW BLACK
7
“From a short pleasure can come a long
repentance.”
French proverb
Tob
acc
a f o cau
car ifth ses
dio
v of
dis ascul
wo ease ar
rldw
ide
.
Risk factor: tobacco
Cardiovascular risks of smoking
C A N A D A
ICELAND
NORWAY
ESTONIA
LATVIA
LITHUANIA
BELARUS
DENMARK
IRELAND
NETH. GERMANY
POLAND
BELGIUM
UKRAINE
CZ REP SLO
LUX.
A
H ROM
FRANCE
SWITZ. SC
S&M
BUL
ANDORRA
ITALY B & H
Percentage increase in risk
The public may believe that the
major risk from cigarettes is lung
cancer, but far more smokers
develop cardiovascular disease –
mainly heart attacks and stroke. In
1940, a link was identified
between cigarette use and
coronary heart disease, and there
is now a huge body of scientific
literature linking tobacco with
CVD. The risks are much higher
in people who started smoking
before the age of 16. Tobacco
use, other than smoking, and
passive smoking are also
implicated as CVD risks.
Smoking promotes CVD
through several mechanisms. It
damages the endothelium lining
of the blood vessels, increases
cholesterol plaques (fatty deposits
in the arteries), increases clotting,
raises LDL-cholesterol levels and
lowers HDL, and promotes
coronary artery spasm. Nicotine
accelerates the heart rate and
raises blood pressure.
A gene has been discovered that
increases smokers’ risk of
developing coronary heart disease
by up to four times. Around a
quarter of the population carries
one or more copies of this gene.
Women smokers are at
particular risk, with a higher risk
of heart attack than male
smokers. Women who smoke
only three to five cigarettes a day
double their risk of heart attack,
while men who smoke six to nine
cigarettes a day double their risk.
32
100%
increase in risk
300%
increase in risk
more than 300%
increase in risk
400%
increase in risk
U S A
ALBANIA
SPAIN
PORTUGAL
TUNISIA
MOROCCO
CUBA
GUATEMALA
ST LUCIA
ST VINCENT &
GRENADINES
BARBADOS
SENEGAL
GAMBIA
CHAD
VENEZUELA
URUGUAY
Adults
• Harms, clogs, and weakens arteries
• Heart attack, angina, stroke
Children
•
•
•
•
MALAWI
ZAMBIA
ARGENTINA
Reduces amount of oxygen the blood can carry
Damages arteries
Early-onset atherosclerosis
Sudden infant death syndrome (cot death)
Men
MAURITIUS
ZIMBABWE
AUSTRALIA
SWAZILAND
SOUTH
AFRICA
Quitt
ing
effec smoking
tiv
reduc ely
es
cardi
o
risk vascular
to
to th close
perso at of a
n
never who has
smoke
d.
Smoking prevalence
p to
A, u die
S
U
e
In th 0 people m
0
0
fro
62
year ase
h
c
a
e
e
e
t dis
hear by passiv
d
e
caus moking.
s
PAPUA
NEW
GUINEA
COMOROS
NAMIBIA
Cardiovascular risks of passive smoking
I N D O N E S I A
UNITED REP.
TANZANIA
BOLIVIA
PARAGUAY
PALAU
MALAYSIA
SINGAPORE
SEYCHELLES
CONGO
PHILIPPINES
THAILAND
SRI LANKA
UGANDA
KENYA
BRAZIL
VANUATU FIJI
NIUE
ETHIOPIA
CAMEROON
SAMOA
LAO
PDR VIET NAM
MYANMAR
TONGA
NIGERIA
CÔTE
D’IVOIRE
ECUADOR
CHILE
NAURU
BANGLADESH
INDIA
YEMEN
SUDAN
GHANA
aortic
aneurysm
NEPAL
OMAN
SAUDI ARABIA
BURKINA
FASO
PAKISTAN
UAE
MALI
MAURITANIA
JAPAN
REP.
KOREA
C H I N A
KUWAIT
BAHRAIN
EGYPT
HAITI
COSTA RICA
PANAMA
peripheral
arterial
disease
MONGOLIA
KYRGYZSTAN
UZBEKISTAN
ARMENIA
AZERBAIJAN
TURKEY
GREECE
SYRIAN ARAB
LEBANON
REP.
IS L . R E P .
ISRAEL
JORDAN
IR A N
DOMINICAN
REP.
JAMAICA
death from
undiagnosed
coronary heart
disease
KAZAKHSTAN
GEORGIA
ALGERIA
MEXICO
stroke; coronary
heart disease;
impotence
RUSSIAN FEDERATION
FINLAND
SWEDEN
UNITED
KINGDOM
Percentage of people aged 18 years and above
who smoke
2003 or latest available data
data from urban populations only
60% and above
15%–29.9%
45%–59.9%
below 15%
30%–44.9%
no data
NEW
ZEALAND
ICELAND
NORWAY
C A N A D A
UNITED
KINGDOM
DENMARK
IRELAND
ESTONIA
LATVIA
LITHUANIA
BELARUS
NETH. GERMANY
POLAND
BELGIUM
UKRAINE
CZ REP SLO
LUX.
SERBIA &
A
H
ROM MONTENEGRO
FRANCE
SWITZ. SC
ANDORRA
BUL
ITALY B & H
Smokers don't know the risks of heart attack
U S A
Percentage of smokers
in the USA
who believe they have
higher-than-average
risk of heart attack
1999
RUSSIAN FEDERATION
FINLAND
SWEDEN
PORTUGAL
MONGOLIA
GEORGIA
UZBEKISTAN
ARMENIA
SPAIN
ALBANIA GREECE
REP.
KOREA
JAMAICA
KUWAIT
BAHRAIN
GUATEMALA
EGYPT
HAITI
MAURITANIA
BARBADOS
VENEZUELA
SENEGAL
GAMBIA
MALI
CÔTE
D’IVOIRE
VANUATU FIJI
NIUE
SRI LANKA
ETHIOPIA
BENIN
CAMEROON
CAMBODIA
THAILAND
PALAU
SEYCHELLES
UNITED REP.
TANZANIA
ZAMBIA
BOLIVIA
NAMIBIA
MALAWI
ZIMBABWE
MAURITIUS
PARAGUAY
SWAZILAND
SOUTH
AFRICA
ARGENTINA
Women
PHILIPPINES
MALAYSIA
SINGAPORE
UGANDA
KENYA
COMOROS
URUGUAY
SAMOA
LAO
PDR VIET NAM
TONGA
NIGERIA
CONGO
CHILE
MYANMAR
SUDAN
BURKINA
FASO
BRAZIL
39%
smokers
with
family
history
of
heart
attack
NAURU
BANGLADESH
INDIA
YEMEN
ECUADOR
48%
smokers
with
high
blood
pressure
NEPAL
OMAN
CHAD
GHANA
49%
smokers
with
angina
PAKISTAN
UAE
SAUDI ARABIA
ST LUCIA
ST VINCENT &
GRENADINES
C H I N A
IS L . R E P .
IRAN
JORDAN
DOMINICAN
REP.
JAPAN
AZERBAIJAN
SYRIAN ARAB
REP.
ALGERIA
CUBA
KYRGYZSTAN
TURKEY
LEBANON
ISRAEL
TUNISIA
MOROCCO
MEXICO
COSTA RICA
PANAMA
39%
heavy
smokers
(40 or
more
per day)
KAZAKHSTAN
oth
of b
%
4
d
Only kers an
o
sm okers in
m
at
nons know th
es
a
Chin ing caus .
smok t disease
hear
I N D O N E S I A
AUSTRALIA
NEW
ZEALAND
33