What happens when you smoke

Tobacco use is dangerous

Tobacco products include cigarettes, electronic nicotine delivery systems (ENDS, includes e-cigarettes and JUUL®), smokeless tobacco (dip or chew), cigars, hookahs and pipes

Tobacco use is especially dangerous to your blood vessels and arteries. It can cause atherosclerosis, a build-up of plaque (fatty substances found in your blood). Over time, the plaque hardens and narrows your blood vessels and arteries.

Smoking also makes the blood vessels and arteries sticky. This leads to “obstructions” in blood flow, meaning that your blood cannot flow easily. The side effects of using tobacco can result in needing stents, coronary artery bypass surgery or both to keep your blood vessels and arteries open. It can also lead to stroke or heart attack.

Tobacco use:

  • causes stroke and heart disease
  • increases your heart rate
  • increases your blood pressure
  • lowers your good (HDL) cholesterol
  • makes your heart work harder (adding stress to scarred or weakened blood vessels and arteries)
  • can interfere with how well your heart medicines work.

Smoking even 1 cigarette a day:

  • causes your heart rate and blood pressure to increase, and your major blood vessels to become smaller, causing your heart to work harder
  • causes your blood to clot faster; tobacco users have a higher chance of stroke and heart attack
  • reduces the amount of oxygen in your bloodstream, making you short of breath
  • slows your ability to heal.

Cigarette smoke contains more than 7,000 chemicals. More than 70 can cause cancer. The human body was not designed to smoke.

Did you know?
  • Smoking doubles your risk for stroke.
  • Smoking causes nearly 1 out of every 3 deaths from heart disease and stroke.
  • Heart disease and stroke cause 1 out of 3 women’s deaths.

Secondhand smoke

Secondhand smoke is a mixture of smoke coming from the burning tips of cigarettes, pipes and cigars and smoke exhaled by smokers.

Anyone around secondhand smoke breathes in the chemicals from the tobacco smoke. Secondhand smoke causes death and disease in people who do not smoke.

Even briefly breathing secondhand smoke can damage the lining of blood vessels and cause your blood to become stickier. These changes can cause a deadly heart attack.

No amount of secondhand smoke is safe. According to the Centers for Disease Control and Prevention, secondhand smoke exposure causes more than 8,000 deaths from strokes.

Smokeless tobacco

Smokeless tobacco products (snuff, chewing tobacco, snus and tobacco products that dissolve) are not a safe alternative to smoking. Any form of tobacco contains many toxic chemicals and high levels of nicotine.

For example, the nicotine levels in 1 tin of smokeless tobacco is roughly equal to 4 packs of cigarettes. These chemicals move from your mouth to all parts of your body through your bloodstream. It affects your heart by increasing your heart rate and blood pressure. This can lead to a stroke.

Smokeless tobacco also contains a lot of sugar. This can make it harder to control your glucose levels.

Did you know?

Dangerous and harmful chemicals have been found in secondhand vape.


Electronic cigarettes (e-cigarettes or e-cigs), JUUL®, hookah pens, vapes, vaporizers, vape pens, e-hookah, e-pens, e-pipes and e-cigars are all known as electronic nicotine delivery system (ENDS).

E-cigarettes have become very popular very quickly. This means there has not been time to get results from long-term studies on the safety or health effects of e-cigarettes.

  • A 2018 public health research report supported by the FDA confirms that using ENDS products is harmful. Use causes health and safety problems and greatly increases tobacco addiction among adolescents.
  • The name of the report is “Public Health Consequences of E-cigarettes” by the National Academies of Science, Engineering, Medicine (NASEM).”
  • The FDA has not approved e-cigarettes as a way to quit smoking. According to the 2018 NASEM report, there is “limited” evidence that e-cigarettes help some people to quit smoking. Many people return to smoking, continue to use the e-cigarette, or use both. None of these options is healthful.

Benefits of quitting tobacco


  • 8 hours: 
    The carbon monoxide level in your blood drops to normal, and the oxygen level in your blood increases to normal. Your breathing starts to improve.
  • 24 hours: 
    Your chance of a heart attack decreases.
  • 48 hours: 
    Nerve endings start to grow again. Your senses of smell and taste improve.
  • 2 weeks: 
    Your circulation improves and your lung function increases.
  • 1 to 9 months: 
    Your cough, stuffy nose, and shortness of breath decrease. Your energy level increases.
  • 1 year: 
    Your chance of heart disease is cut in half.
  • 5 years: 
    Your chance of a stroke is the same as someone who does not use tobacco. Your chance of dying from lung cancer is cut in half.
  • 5 to 10 years: 
    Pre-cancerous cells are replaced with normal cells.
  • 10 years: 
    Your risk of cancer, stroke and heart disease is close to the same of someone who never used tobacco.

(Source: World Health Organization)

Did You Know?

In 1 year of quitting smoking, your risk of heart disease is reduced by more than half. Quitting also reduces the risk of a second heart attack if you’ve already had one.

Behavioral tips and coping skills for quitting tobacco

Getting started

  • Make a list of reasons for quitting.
  • Think positively.
    • Believe you can.
    • Remind yourself, "I'm choosing not to smoke today."
    • Remember that it's "not that I can't smoke, it's that I'm choosing not to."
    • Tell yourself often: "I can do this."
    • Visualize yourself as someone who doesn't use tobacco.
  • Use relaxation breathing.
    • Inhale to count of eight.
    • Hold to count of four.
    • Exhale to count of eight.
  • Substitute items for cigarettes.
    • Chew gum.
    • Suck on hard candy.
    • Chew on straws or toothpicks.
    • Eat low-calorie snacks.
  • Keep your hands busy.
    • Play cards.
    • Read books.
    • Put together puzzles.
    • Play with rubber binders/bands.
    • Make crafts.
    • Write letters.
    • Draw.
    • Paint.
  • Concentrate on the good things in your life!
  • Change your environment:
    • Change your routine to help avoid temptation. Even small changes can lower the craving to smoke.
    • Get rid of all cigarettes, ashtrays and lighters in your home, car, desk or office.
    • Change your favorite smoking areas to make them remind you less of smoking.
    • Make your home and vehicles smoke free.
  • Get support from others:
    • Talk to your family, friends or coworkers about how to support you while you quit.
    • See if others you know would like to quit with you. This way you can support each other through the tougher times of quitting.
  • Plan your reward for each day you do not smoke. Think about small, pleasurable activities you can do during your day that give you joy. Long-term rewards are helpful as well, but the small rewards are just as important
  • Remember that even the most intense craving lasts only five to 10 minutes. Wait it out. Tell yourself, "This too shall pass."

Avoiding a relapse

  • Think about what you are gaining from quitting tobacco, instead of focusing on what you've given up. For example, "It's easier to play with my kids or grandkids."
  • Have a plan for how you will deal with unexpected urges. (Take a walk, make a call.)
  • Think your way through difficult situations ahead of time whenever you can.
  • Think about past quitting attempts and what was helpful to you. Reuse them again if possible or try something new.
  • Explore ways to move your body with safe and realistic expectations. Increasing your physical activity can help you manage weight gain and work through emotions that otherwise would make you want to smoke.
  • Avoid foods high in calories and fat. Sugar can increase cravings to smoke. Limit large amounts of sugar.
  • Drink lots of water. Ice water may be helpful in getting rid of a craving.
  • Reward yourself when you reach milestones: one day, one week, two weeks, one month, etc.
  • Go to places where you cannot smoke—stay away from the places you used to smoke.
  • Think about the money you saved!
  • Think of quitting as an act of love—for those you care about and for yourself!

Resources for quitting tobacco 

Allina Health

  • Tobacco Intervention Program at Abbott Northwestern Hospital:
  • Tobacco Intervention Program at Mercy Hospital:
  • *Penny George™ Institute for Health and Healing (LiveWell Center) tobacco intervention coaching:
  • Tobacco Intervention Program at River Falls Area Hospital:
  • *Allina Health United Lung and Sleep Clinic Tobacco Cessation Program:


*There may be a cost to you. Check with your insurance provider.

Source: Allina Health Patient EducationUnderstanding Stroke, fifth edition, neuro-ahc-90662
Reviewed By: Allina Health Patient Education experts
First Published: 02/01/2006
Last Reviewed: 05/01/2018

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