Another Reason to Quit Smoking – NOW

Researchers have found smoking is a stronger risk for peripheral artery disease than for heart attacks and stroke. That’s another reason to quit smoking ― NOW.

If you smoke, you no doubt already know you are not doing your lungs any favors. You’re raising the odds for developing lung cancer and chronic obstructive pulmonary disease. You are also at elevated risk for heart attack and stroke. Johns Hopkins Bloomberg School of Public Health researchers have now identified an even stronger health risk linked to smoking ― peripheral artery disease (PAD).

The PAD risk can remain elevated for even 30 years after a person gives up cigarettes. But that doesn’t mean there’s no point in stopping smoking. Kicking nicotine addiction will begin to lower your odds of developing PAD. And if you already have the condition, smoking cessation and other lifestyle changes can help prevent serious complications. And that’s another reason to stop smoking ― now.

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The PAD and smoking connection

Plaque is fatty, artery-clogging material made up of cholesterol, calcium, fibrous tissue, and other substances in the blood. Atherosclerosis develops when plaque builds up in arteries carrying blood to your brain and heart. It can cause strokes, transient ischemic attacks (TIAs, or mini strokes), and heart attacks. When it builds up in your leg arteries, the result is PAD.

This form of atherosclerotic artery disease limits flow of oxygen-rich blood to your limbs, causing numbness and pain, which can limit your ability to exercise or even walk up and down stairs. The poor circulation resulting from PAD can also put you at risk for leg infections, including hard-to-treat ones. In fact, if the blocked blood flow to a limb is severe enough, gangrene (tissue death) may develop, requiring leg amputation, according to the National Heart Lung and Institute (NHLBI).

The Johns Hopkins study, published in the Journal of the American Heart Association (JAMA), analyzed smoking and atherosclerotic disease in a large group of people participating in the ongoing, long-term Atherosclerosis Risk in Communities (ARIC) study. To look for smoking-elevated risks of coronary heart disease, stroke, and PAD, the investigators studied ARIC data from 13,335 people (including 3,323 current smokers and 4,185 former smokers) collected over the course of 26 years.

The research team used “pack-years” to measure how much and how long people smoked. For example, 10 pack-years can mean smoking one pack of cigarettes per day for 10 years or smoking two packs daily for five years, or some other combination. The results showed people who smoked for more than 40 pack-years had 1.8 times more risk for stroke and 2.1 times the risk for coronary heart disease compared to people who never smoked.

But the risk for PAD was even higher. The 40-pack years smokers had about four times the risk for peripheral artery disease than non-smokers.

Bottom line? This is another reason to stop smoking – NOW!

The smoking risk for PAD wasn’t only stronger than the risk for stroke or heart attack, it lasted longer, too. It takes about 30 years of smoking cessation for the PAD risk for former smokers to become as low as the risk for people who never smoked. But there is hopeful news from the study, and it’s another reason to quit smoking now, not later.

Although it’s true that it takes decades of non-smoking to lower a former smoker’s risk for PAD back to the same level as those who never smoked, giving up cigarettes results in a meaningful drop in peripheral artery disease fairly quickly.

"We observed a lower risk for peripheral artery disease, coronary heart disease, and stroke within five years of smoking cessation," said researcher Ning Ding, a data analyst at the Bloomberg School and first author of the study.

The research team found those who stopped smoking for five to nine years had a 57 percent reduction in PAD, and a 30 to 40 percent for coronary heart disease and stroke, compared to those who never smoked.

Learn about PAD and how to prevent it

"Our results underscore the importance of both smoking prevention for non-smokers and early smoking cessation for smokers. The study also suggests that campaigns about smoking's health risks should emphasize the elevated risk of peripheral artery disease, not just coronary heart disease and stroke," said Bloomberg School of Public Health researcher and epidemiologist Kunihiro Matsushita, MD, PhD.

If you have leg pain when you walk or climb stairs, especially if you have a history of smoking, don’t assume it’s a normal part of aging ― talk to your doctor about being tested for PAD, the NHLBI emphasizes. A simple, non-invasive test, called an ankle-brachial index, or ABI, can determine whether you likely have PAD.

And if you do smoke, you have another reason to quit smoking now. Work with your doctor on a successful smoking cessation plan to lower your risk of PAD. If you already have the condition, lifestyle changes including losing excess weight, getting regular exercise, eating a heart healthy diet and, of course, stopping smoking can help lower the risk for serious complications.

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