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LETTER | Cardiovascular disease is a ‘smoking illness’

LETTER | Cardiovascular disease is an umbrella term which includes all types of diseases affecting the heart or blood vessels. It mainly consists of coronary heart disease (which may present acutely as a heart attack, stroke or heart failure).

According to a large study in the United States, at least one in five male smokers or one in 10 female smokers would die earlier due to a cardiovascular disease event. The same group of researchers also found that young smokers (between 20 and 40 years old) were at least twice as likely as young non-smokers to die of a heart attack throughout their life.

Smoking is one of the most well-known behavioural risk factors for cardiovascular disease. Thousands of harmful chemicals are contained in cigarette smoke which can lead to multiple adverse health effects.

Besides being an addictive compound, nicotine in cigarette smoke may lead to abnormal blood thickening and subsequently, a higher chance of blood clot formation in the major blood vessels.

Oxidative damage and narrowing of the blood vessel space may also occur. As a result, a heart attack can happen if a formed blood clot blocks the circulation in a coronary artery (which supplies blood to the heart muscle).

Tobacco use doubles the risk of getting a heart attack. Co-existence of another major risk factor (such as diabetes, high blood pressure, high cholesterol or obesity) may triple or even quadruple the risk.

Based on the results of the National Cardiovascular Disease database, around 93 percent of heart attack patients had at least one of the common cardiovascular risk factors.

In the 2018 – 2019 registry report, notably up to 34 percent of heart attack patients were current smokers, with a worryingly increasing trend of them being active smokers over the two years (from 33.9 percent in 2018 to 34.5 percent in 2019).

Cut out bad habit

Quitting smoking cuts the risk of cardiovascular disease dramatically. If a smoker quits smoking and persists to not smoke for 15 years, the risk of coronary heart disease would decrease to that of a non-smoker.

Research has also shown that mortality reduces by 36 percent for ex-smoker patients with coronary heart disease compared with smokers.

So, if you smoke, you should give it up as soon as possible by seeking professional help at the local quit smoking clinic of designated medical facilities.

It was previously thought that heart attack would affect older adults more often than young adults. Such assumption may not apply fully nowadays as young adults are potentially exposed to similar risk factors of cardiovascular disease.

Banning the sale of tobacco products including electronic vaporisers to Malaysians born after Jan 1, 2007, means that those 18 years old (equivalent to the current legal age for smoking) or younger in two years will not be allowed to purchase cigarettes or vaping products legally.

This effort dubbed the ‘Generational End Game’ by the Health Ministry is commendable to reduce the number of young smokers in Malaysia.

Indeed, one of the best things you can do to maintain good cardiovascular health is not to use tobacco in any form (or quit smoking if you do smoke).


DR YAP JUN FAI, PROF DR MOY FOONG MING and DR LIM YIN CHENG are affiliated with the Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya and the Department of Public Health, Universiti Malaya Medical Centre.

The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.

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