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PLOS Medicine Study Finds No Safe Level of Daily Smoking for Heart Health

A pooled analysis of 22 long-term cohorts totaling more than 320,000 people quantifies a steep early cardiovascular risk from even a few daily cigarettes.

Overview

  • Researchers report that smoking just two to five cigarettes per day is linked to roughly a 50–60% higher risk of coronary events compared with never-smokers.
  • Active smokers show markedly elevated risks across heart attack, stroke, reduced cardiac pump function and atrial fibrillation, with all-cause mortality up to 2.5 times higher.
  • The analysis demonstrates a clear dose–response, with the steepest risk jump occurring at the transition from not smoking to occasional smoking.
  • Cardiovascular risk declines after cessation, with noticeable improvement within three to five years and risks for coronary events and stroke nearing never-smoker levels about 10 years after quitting.
  • In Germany, adult smoking prevalence and total cigarette consumption have fallen since 2000, though consumption rose 3.5% last year and tobacco use is linked to an estimated 127,000 premature deaths annually.