Smoking Leads to High Blood Pressure

Effect on your cardiovascular health and the impact of quitting

Smoking causes hypertension (high blood pressure) in the short term and over a long period of time. This puts both young and older smokers at higher risk of developing high blood pressure when compared to those who do not smoke.

A longitudinal study of nearly 29,000 people, ages 36 to 80, found that smoking not only raises blood pressure over time but also puts you at higher risk of developing atherosclerosis, a chronic and progressive disease in which plaques build up in the walls of arteries. The study cites smoking as an independent risk factor for cardiovascular disease.

Smoking raises your blood pressure immediately by activating your sympathetic nervous system. Long-term smoking contributes to the development of chronic high blood pressure by accelerating arterial aging, or how quickly the arteries become damaged.

Can Smoking Affect Your Blood Pressure?

Smoking leads to high blood pressure, a condition in which the pressure on the walls of your arteries is higher than normal. This means your blood is pushing on the walls of the arteries.

Too much pressure on the blood vessel walls, especially over a long period of time, can cause them to rupture or put you at higher risk for stroke, heart disease, heart attack, and kidney failure. Keeping a normal blood pressure of 120/80 mmHg for adults is recommended.

Systolic and Diastolic Blood Pressures

Verywell / JR Bee

Effects of Smoking on Your Cardiovascular System 

Cigarette smoking is a major preventable cause of premature cardiovascular disease, with the risk particularly high in people with high blood pressure. Cigarette smoking increases the likelihood of having a heart attack or stroke because it adds to the damage done to the blood vessels by high blood pressure and high cholesterol levels.

Chronic smoking also stiffens the arteries, making them less flexible as blood passes through them. The heart has to work harder to move blood through the body in cigarette smokers.

Nicotine, the addictive chemical found in combustible cigarettes and other tobacco products, has been found to acutely increase blood pressure through its effects on the sympathetic nervous system. Therefore all people, especially those who already have hypertension, should quit smoking as soon as possible.

Many people, including cigarette smokers, are unaware that they have high blood pressure because the symptoms are nonspecific and therefore can be attributed to many other medical conditions.

High Blood Pressure Symptoms

High blood pressure symptoms include:

  • Headaches
  • Nose bleeds
  • Confusion
  • Blurry vision or other vision problems
  • Chest discomfort or pain
  • Dizziness or lightheadedness
  • Feelings of anxiety
  • Shortness of breath
  • Irregular heartbeat 
  • Pounding sensation in your chest
  • Blood in urine

Risks of High Blood Pressure

As previously mentioned, high blood pressure puts you at higher risk of developing:

  • Kidney disease
  • Heart attack
  • Stroke

Other complications include:

  • Dementia or Alzheimer's disease
  • Sexual dysfunction
  • Peripheral artery disease

Some research has also found that smoking may blunt the effects of blood pressure medication such as amlodipine, thereby reducing the drug's ability to mitigate high blood pressure and stiffening of the arteries.

If you experience any symptoms of high blood pressure, call 911 or visit the nearest emergency hospital right away to help avoid these life-altering and sometimes fatal complications. 

Does Quitting Smoking Lower Blood Pressure?

Quitting smoking along with other lifestyle changes can help to lower your blood pressure. These changes include:

  • Eating a low-sodium diet
  • Getting regular exercise
  • Maintaining a healthy weight
  • Limiting alcohol intake

Quitting early in life is best to avoid irreversible damage to blood vessels, but even if you are a longtime smoker it is never too late to quit. Smoking also increases your risk of other conditions like lung cancer, COPD, and emphysema, so the health benefits of quitting are significant.

In the United States, the estimated number of tobacco smokers has dropped, as a result of tobacco-control efforts, from 45.1 million smokers in 2005 to 36.5 million smokers in 2017. That number is expected to continue to drop although the rise in smokeless tobacco use also poses health risks.


The most effective way to prevent hypertension is to eliminate unhealthy habits like smoking. Not only does smoking and exposure to secondhand smoke raise your blood pressure, but it also puts you at a higher risk for heart attack and stroke. The only way to be sure that you are not being negatively impacted by smoking is to avoid it altogether.

Although much progress has been made, far too many young people use tobacco. Even more troubling, the rates of decline for smokeless tobacco have stalled or risen as of late. This is of particular concern because nicotine addiction can prolong tobacco use and lead to severe health complications.

As a result, the medical and public health communities cannot emphasize enough the importance of discouraging all forms of tobacco use in young people. 

A Word From Verywell

High blood pressure is often called a silent killer because of the absence of symptoms. It's important to know your risk factors and adopt healthy lifestyle choices, including diet and exercise. Smoking affects your blood pressure and is a significant risk factor, so make a point of avoiding tobacco use altogether.

Frequently Asked Questions

  • Does nicotine alone raise blood pressure?

    Nicotine is the primary cause of high blood pressure when you smoke. This is because of the chemical response that nicotine causes in your body. But cigarette smoke also contains other chemicals, and more research is needed to understand how it affects blood pressure.

  • How many cigarettes a day is heavy smoking?

    Definitions may vary, but heavy smoking is generally defined as 15 to 20 cigarettes a day. That compares with 10 to 19 cigarettes for moderate smokers and less than 10 for light smokers.

  • What happens after one week of not smoking?

    Within minutes and hours of not smoking, your heart rate decreases and the carbon monoxide level in your body drops to normal. It won't be long until your lung function begins to improve. You also may experience nicotine withdrawal and side effects, but the benefits outweigh these risks.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Benowitz NL, Burbank AD. Cardiovascular toxicity of nicotine: Implications for electronic cigarette useTrends Cardiovasc Med. 2016;26(6):515-523. doi:10.1016/j.tcm.2016.03.001

  4. Appell LA. Smoking and Hypertension. UpToDate.

  5. Freitas SRS, Alvim RO. Smoking and Blood Pressure Phenotypes: New Perspective for an Old Problem. Am J Hypertens. 2017 Jun 1;30(6):554-555. doi:10.1093/ajh/hpx039.

  6. Chang JT, Anic GM, Rostron BL, Tanwar M, Chang CM. Cigarette Smoking Reduction and Health Risks: A Systematic Review and Meta-analysis. Nicotine Tob Res. 2021 Mar 19;23(4):635-642. doi:10.1093/ntr/ntaa156.

  7. American Lung Association. Benefits of Quitting.

  8. Centers for Disease Control and Prevention. 7 Common Withdrawal Symptoms.

By Shamard Charles, MD, MPH
Shamard Charles, MD, MPH is a public health physician and journalist. He has held positions with major news networks like NBC reporting on health policy, public health initiatives, diversity in medicine, and new developments in health care research and medical treatments.