First let’s understand how the tobacco in your cigarette contains chemicals that damage the heart. Nicotine increases your blood pressure, which means extra stress on the heart. It reduces the supply of oxygen to your heart and other organs. And the tar from smoking coats your lungs like soot, causing breathing difficulties. Tar contains carcinogens.

Smoking changes the walls of the arteries, causing them to narrow down. Over time plaques build up, cause blockages and result in a heart attack. Smoking interrupts the functioning of genes in external walls of the arteries, thickening them with deposits of scar tissue and causing what’s called fibrosis, which unfortunately cannot be reversed.

HOW QUITTING SMOKING IMPACTS THE HEART

Of course, once you have had a heart attack, you cannot undo all of the damage or return the heart to the normal functioning levels of a non-smoker. But after five years of giving up smoking, your risk of another heart attack reduces by 60 per cent.

The changes are slow and not discernible in the beginning. In the first few weeks, the heart rate slows down, the blood pressure stabilises and the level of carbon monoxide in your blood drops. In the first two years, there are no changes in the arteries as such but the clotting tendency of blood reduces. Nicotine increases the number of platelets, which clump together and make the blood sticky. This increases the risk of blood clots that trigger a heart attack.

By the end of the second year, the lining of the artery walls becomes smoother. Significantly, by this time lung functioning improves greatly. You could get rid of what we call the smoker’s cough as the lungs clear themselves of mucus, tar and dust. You would not be coughing up phlegm and most importantly, you will stop being anxious. You may think nicotine relaxes you but studies prove it aggravates anxiety.

Between the third and fifth year, the inflammation of the artery walls goes down by 90 per cent, they become smoother and platelet function improves. There is no spasm in the arteries.

WHAT HAPPENS WHEN YOUR DECISION TO QUIT IS HALF-HEARTED?

For this, you need to develop mental strength. Depending solely on nicotine patches to do the job is not worthwhile as 50 per cent of users go back to smoking in a year.

Also, patients have this habit of lapsing back to casual smoking. They argue that they may smoke one or two cigarettes while socialising with peers. Even smoking on occasion can elevate your risk of heart attack by up to 30 per cent compared to non-smokers.

Some patients gain weight in the early days after giving up smoking. Since your body is addicted, it seeks something else to negate craving, and that’s usually food. But that too shall pass considering its bigger health benefit.

(Dr Gupta is Chair, Preventive Cardiology & Medicine, Eternal Heart Care Center & Research Institute, Mount Sinai NY Affiliate, Jaipur)