Smoking & Heart

Smoking is a practice in which a substance is burned and the resulting smoke is breathed in to be tasted and absorbed into the bloodstream.

Dr. Milan Gupta, MD, FRCPC, Cardiologist, discusses Smoking and the Risks to your Heart – Cardiologist

Quiz: Do You Understand Smoking Cessation?

Test your knowledge by answering the following questions:


Smoking is solely a physical addiction.

Smoking is both a physical and a psychological addiction, and many people use it to cope with stress, depression or anger.

Your body goes through withdrawal symptoms when you quit smoking.

When you remove the nicotine fix, your body begins to experience withdrawal symptoms and cravings.

You don't need a prescription for all types of smoking cessation aids.

Nicotine replacement therapy (NRT) products can be helpful. These are non-prescription medications that contain nicotine to reduce withdrawal symptoms.

Prescription drugs can help with cravings but not withdrawal symptoms.

Prescription drugs can help you manage cravings and withdrawal symptoms.

Smoking is an appetite suppressant.

Many people who quit smoking gain weight. Smoking is an appetite suppressant, so it’s important to be mindful of your eating habits while you’re quitting smoking.
(Answer all questions to activate)

Dr. Daniel Ngui, BSc (P.T), MD, CFPC, FCFP, Family Physician, discusses smoking.

What Medications Help Smoking Cessation?

Dr. Milan Khara, MBChB, CCFP, ABAM, discusses why smoking is addictive.

The evidence tells us that when people use smoking cessation medications they’re more likely to be successful in quitting.

There are three main classes to smoking cessation medications. The first is the nicotine replacement therapies, also known as thes. The nicotine replacement therapies consist of a patch, the gum, the lozenge, the inhaler and we also have an oral spray as well.

It’s a good approach to smoking cessation, and all are available over the counter and the evidence suggests that if you use one of those products, you’ll approximately double the likelihood of success compared to using nothing.

The second smoking cessation medication class is the antidepressants, in fact, of which there is only one and that is bupropion. Bupropion started out in life as an antidepressant and was noticed serendipitously to increase the likelihood of quitting smoking and again, the evidence suggests that this will approximately double your likelihood of success when compared to using nothing. So, bupropion is a good agent that we still use.

And, the last class of smoking cessation medications is a medication called verenicline. This is the newest smoking cessation medication that has been available since 2007 and the way that this works is that the verenicline molecule goes into the brain and lands in the same receptor where nicotine from the cigarette would land and essentially fools the bran into believing that it doesn’t need to see the nicotine from a cigarette.

So, there is a menu of options available when we think about the choices of smoking cessation medications. In fact, sometimes it may be wise to use a combination with more than one of these products. It’s valuable to discuss with a healthcare professional, which may be the best option for you.

Smoking and the Risks to your Heart

Smoking is an incredibly powerful risk factor for developing blocked arteries, and that’s what leads to heart disease.

But blocked arteries also lead to stroke; blocked arteries in the legs can lead to pain on walking, and ultimately, to amputation. Smoking is a critical risk factor. Smoking is even more important as a risk factor if we consider when smoking starts.

Most people start smoking at a young age, in their teen years. And we know that the risk associated with smoking for developing plaque buildup in the arteries starts right around that time; it doesn’t start 20 years into smoking. And therefore all of the efforts at preventing our youth from taking up this risky habit.

Often, people who smoke will rationalize and say, “Well, I only smoke two cigarettes a day; I don’t smoke a pack a day.” In fact, there is a clear dose response relationship between the number of cigarettes smoked per day and the risk of developing heart disease, lung disease, cancer.

Recent studies have shown that even people who smoke two cigarettes a day double their lifetime risk for heart attack. Someone who smokes a pack a day can increase their risk for heart attack up to 10 times that of a non-smoker.

There are so many medical and societal reasons to quit smoking, and we all understand those. But quitting is not easy for everyone. Some people are able to quit without the aid of medication.

We do have effective medications now that can assist with smoking cessation. People have been concerned that these medications may be associated with risk of heart attack paradoxically, particularly in smokers who already have heart disease.

And the reassurances that these medications do not increase the risk of heart attack and in fact smokers – especially those with heart disease – should strongly consider these drugs to assist them with smoking cessation.

If you are a smoker, if you want to learn more, absolutely speak with your family physician. They could provide you with advice, treatment options and referrals to smoking cessation programs and specialists that can help you.

Presenter: Dr. Milan Gupta, Cardiologist, Brampton, ON

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