Tobacco and cardiovascular diseases: major, early and often fatal risks

The Court of Auditors report of 2012 highlighted the superficial knowledge of the risks of smoking and the major underestimation of the health damage caused by these products. Few of us know in detail the real and concrete risks linked to tobacco consumption, apart from lung cancer.

This is particularly the case for its cardiovascular impact which has three particularities:

• An absence of a consumption intensity threshold in the relationship between smoking and cardiovascular accidents. This is linked to an extreme sensitivity of the mechanisms (inflammation, coagulation, arterial spasm) at the origin of these accidents. Thus, a smoker of one to five cigarettes per day has half the risk of coronary disease or stroke of a smoker of twenty cigarettes.¹. Even simple exposure to passive smoking increases the risk of myocardial infarction by about 25 to 30% in non-smokers and up to 60% in² in the most exposed subjects, i.e. a risk similar to that of smokers of 1 to 9 cigarettes/day.³.
• A great precocity of events. This sensitivity of the mechanisms explains why smoking is the main and often isolated cause of heart attacks in young people, on arteries that are still little or not at all damaged. In France, around 80% of heart attack victims before the age of 50 are smokers.⁴ both in men and women and 80 % of these smokers who suffered early heart attacks did not present any other risk factors (hypertension, diabetes, etc.)⁵
• A very rapid benefit from weaning. While quitting smoking is beneficial at any age, this is particularly true for cardiovascular diseases. Given the rapid correction of the mechanisms involved, the risk of heart attack decreases very quickly and the risk of coronary disease is on average half that of a smoker after one year of quitting. It can even quickly reach that of a subject who has never smoked if quitting occurs before the age of 30.⁶ and the residual risk mortgage is all the lower the earlier the withdrawal was.