Smoking and Cardiovascular Disease

BEHAVIORAL RISK FACTOR

Smoking and Cardiovascular Disease

Tobacco use is one of the clearest behavioral risk factors linked to cardiovascular disease. It contributes to arterial damage, clot formation, blood pressure increases, and higher risk of heart attack and stroke.

RISK

Health impact of tobacco exposure

2–4×

higher risk of coronary heart disease among smokers

2–4×

higher risk of stroke compared with nonsmokers

1 in 4

U.S. cardiovascular disease deaths attributed to smoking

25–30%

higher stroke risk among nonsmokers exposed to secondhand smoke

Relative risk linked to tobacco exposure Percent higher than the comparison group

Ranges convert the cited 2–4× risks into percent higher than the comparison group.

COUNTRY-YEAR REGRESSION

Is higher tobacco use associated with higher CVD mortality?

Across 1,902 country-year observations from 98 countries, a one-percentage-point increase in tobacco-use prevalence was associated with 5.46 additional age-standardized CVD deaths per 100,000 people.

5.46

Regression slope

Additional CVD deaths per 100,000 for each 1-point increase in tobacco prevalence.

0.362

Correlation (r)

Positive pooled association between tobacco prevalence and CVD mortality.

0.131

R-squared

Share of pooled outcome variation described by the simple linear model.

1,902

Observations

Matched country-year records spanning 2000–2023.

Model: ŷ = 77.33 + 5.46x, where x is tobacco-use prevalence in percent. This is an unadjusted country-level association, not evidence of causation. Of the tobacco values, 576 are WHO estimates and 1,326 are interpolated between estimate years. Repeated country observations are not independent, so no p-value is reported.

Tobacco exposure blood-vessel damage plaque and clot formation reduced blood flow heart attack or stroke

Smoking damages vessel linings, increases hypertension, lowers HDL cholesterol, and promotes atherosclerosis and clotting. Secondhand smoke is also harmful. These estimates are relative-risk associations, not a full explanation of all deaths in a country. Explore the country-year tobacco graph on the Predictors tab.