Smoking and Peripheral Artery Disease

Smoking and tobacco use increase risk of cardiovascular problems, and this is equally true of peripheral artery disease (PAD). PAD is the result of atherosclerosis in the peripheral arteries to the legs, stomach, arms and head — most commonly in the arteries of the legs. PAD is a serious medical condition affecting 8.5 million Americans by age 40 and over 200 million people worldwide.

Tobacco use is a strong risk factor for developing PAD and for worsening of the disease. Some studies suggest that quitting smoking is associated with lower rates of some symptoms, serious complications and death in patients with PAD.

Patients with PAD who smoke or use other forms of tobacco should quit. They should also avoid secondhand smoke. To help patients quit, healthcare providers are encouraged to help develop a quit plan that includes drug therapy, smoking cessation programs, or both. In a large random controlled trial, a combination of both increased the rate of quitting to about 21 percent compared to less than 7 percent with the standard advice to quit smoking.

Recent guidelines identified three types of drug therapy that are effective — varenicline, buproprion and nicotine replacement. Investigators found that all three independently or in combination were effective. And the really good news is that none of these medicines increased rates of cardiovascular events in PAD patients. There is sparse evidence that electronic cigarettes are helpful in getting smokers to quit.

As for passive smoking, there is some evidence that PAD increases in those exposed to secondhand smoke. There has been little to no investigation of whether avoiding secondhand smoke improves outcomes for those who already have PAD.

Whether you have PAD or not, quitting smoking is one of the best things you can do for your health. If you have PAD and smoke, talk with your doctor about the best cessation methods for you. Elizabeth Beard, a former caregiver to family members with cardiovascular disease and a survivor of a bi-femoral aortic bypass for Severe PAD, shares her challenges with quitting on the AHA Support Network Blog.

Quitting smoking is a gift to yourself and those you love. Here are some tips:

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