Smoking’s Deadly Threat to the Heart Often Overlooked
Dr. Saeed Ahmad Ali
Lahore: Smoking is widely recognised as a major cause of lung cancer, but experts warn that its devastating impact on the heart and blood vessels remains less understood, contributing to millions of preventable deaths worldwide each year.
A growing body of research indicates that tobacco use is responsible for more than two million cardiovascular deaths globally every year, highlighting a health burden that extends far beyond the lungs.
Experts say cigarette smoke contains thousands of toxic chemicals, including nicotine, tar and carbon monoxide, which can damage blood vessels, trigger inflammation and increase the risk of heart attacks, strokes and other cardiovascular complications.
A recent international study involving more than 240,000 smokers across 46 countries found that while most participants understood the link between smoking and lung cancer, awareness of its association with heart disease, heart attacks and strokes was considerably lower.
The study, published in BMJ Open, also found that many smokers were unaware that exposure to tobacco smoke could increase cardiovascular risks for other people.
A risk that starts with every cigarette
Pulmonologists in Lahore say there is no safe level of smoking, stressing that repeated exposure gradually damages the respiratory and cardiovascular systems.
Consultant Pulmonologist Dr Imran-ul-Hassan of PKLI & RC said every cigarette exposes the body to numerous cancer-causing substances and toxic compounds that progressively damage lung tissue and trigger chronic inflammation.
He said smoking is a leading preventable cause of illness and death, contributing to chronic obstructive pulmonary disease (COPD), worsening asthma and substantially increasing the risk of lung cancer and cardiovascular disease.
Dr Zeeshan Ali, another Lahore-based pulmonologist, said prolonged smoking can cause COPD by damaging air sacs and inflaming the airways, eventually making breathing increasingly difficult.
He added that tobacco smoke also damages cellular DNA and exposes lung tissue to carcinogens, increasing the risk of cancer, heart attack, stroke and other serious illnesses.
Smoking can also lead to chronic bronchitis, characterised by persistent coughing and mucus production, while heavy smoking may make asthma attacks more difficult to control.
Pakistan faces a major tobacco burden
The health impact is particularly concerning in Pakistan, where an estimated 160,000 people die each year from tobacco-related diseases, according to figures cited in the report.
Experts say the scale of tobacco-related deaths demonstrates the need to shift public awareness from focusing primarily on lung cancer to recognising the wider consequences of smoking, particularly its effects on the cardiovascular system.
They also stress that quitting can substantially reduce health risks, with nicotine replacement therapies, behavioural support and lifestyle changes potentially helping smokers break their dependence.
Awareness gap challenges tobacco control
Despite years of health campaigns, graphic warnings and tobacco-control measures, researchers say an important awareness gap persists.
People may recognise that smoking can cause lung cancer while remaining less aware that tobacco use can damage arteries and significantly increase the risk of heart attacks and strokes.
Experts believe closing this knowledge gap should become a central part of tobacco-control campaigns, particularly among young people and those who underestimate the cardiovascular consequences of smoking.
Punjab tightens restrictions
Meanwhile, Punjab has continued to enforce anti-tobacco regulations under the Prohibition of Smoking and Protection of Non-Smokers Health Ordinance, 2002.
The regulations prohibit smoking and tobacco use in designated public places, including offices, schools, hospitals, public transport and public parks.
The provincial government has also prohibited smoking, vaping, use of e-cigarettes and tobacco products in public parks, while banning their sale at tuck shops, cafes and vending points within or around these spaces.
Authorities have repeatedly issued notifications enforcing relevant provisions of the ordinance, with violations punishable by fines ranging from Rs1,000 to Rs100,000, depending on the nature and frequency of the offence.
For health experts, however, regulations alone may not be enough. They argue that stronger enforcement must be accompanied by sustained public education so that smokers understand that the danger is not confined to their lungs, the heart, brain, blood vessels and people exposed to second-hand smoke are also at risk.
