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If you have coronary artery disease (CAD), quitting cigarettes will cut your risk of death by about 30%. It’s the most important thing you can do for your health.

Research points to proven ways to stop. Certain medications help your body get used to not smoking. Plus, experts and friends can support your goal of leaving cigarettes behind for good.

David Abrams, PhD, a psychologist at New York University, has worked with people to end their smoking habits for decades. “You can quit if you keep trying and find the combination of things that work for you,” he says.

How Smoking Affects Coronary Arteries

CAD “is accelerated by cigarette smoking,” says Neal Benowitz, MD, a professor of medicine at the University of California, San Francisco. Almost 1 in 3 deaths from heart disease are due to smoking or being around other people’s smoke.

Benowitz said that quitting is important for many reasons:

  • Plaques. People with CAD have fatty materials called plaques that make it harder for arteries to send blood to the heart. Smoking causes these plaques to build up faster, increasing the risk of heart attacks.
  • Carbon monoxide. Cigarettes bring carbon monoxide into the body. This deadly gas reduces the flow of oxygen to the heart.
  • Other chemicals. Cigarette smoke carries a mix of other toxic particles that damage cells and cause inflammation and blood clots.
  • Nicotine. The nicotine from cigarettes may cause your heart to beat faster and harder, which ups its need for blood. At the same time, nicotine narrows your vessels, so less blood can pass through. Nicotine also spikes adrenaline. That can lead to heart arrhythmias.
  • Bad effect on CAD treatments. Smoking may offset the benefits of some CAD medicines.

How Quitting Helps

Your whole body’s health — including your coronary arteries — will get a major boost if you quit cigarettes. “A year or two after you stop smoking, your chance of survival is 50% better,” Benowitz says.

And you may see other signs of better health within the first year:

  • 12 hours after your last cigarette, the carbon monoxide in your blood drops to the level of a nonsmoker.
  • Your heart attack risk starts going down after just 1 day.
  • After 2 days, food may start to taste better.
  • At 3 months, your blood flow improves and you’ll be able to exercise for longer.
  • By 9 months, you should notice less coughing.

People who’ve had a heart attack reduce their risk of having another one by 40% if they quit smoking. And 5 years after you stop, your risk of a stroke will be the same as if you’d never smoked.

Stop Smoking With Nicotine and Other Drugs

After your CAD diagnosis, your doctors may tell you about the best ways to stop smoking. You’re more likely to quit for good if you choose the paths that are backed by research.

Your body will crave cigarettes for the first few months without cigarettes. But this desire should lessen each day. As part of withdrawal, you might have coughing, headache, and a sore throat. Hang in there! Those things will pass.

Going “cold turkey” can be tough. People who try that often fail in the first 3 days because that’s the worst time for withdrawal symptoms. But “any way smokers can quit is beneficial,” Abrams says. “Some people just don’t like dragging it out.”

During a hospital stay for CAD, doctors may start you on therapy that replaces cigarettes with nicotine. This includes a patch that provides constant nicotine. When you feel a strong need to smoke, you can also use chewing gums and lozenges, which provide more nicotine.

Other drugs can help, too, such as bupropion and varenicline. They can have side effects, so ask your doctors what method is best for you. A study of 8,000 smokers found that nicotine replacement, bupropion, and varenicline were safe for people who’ve had heart attacks and other sudden cardiac events.

Even so, “If you have coronary disease, and you’re able to quit smoking, you should probably stop nicotine at some point in time,” Benowitz says. The nicotine patch, gum, and lozenge aren’t as addictive as cigarettes because they send nicotine to the brain much more slowly.

E-cigarettes, or “vapes,” raise nicotine levels just as fast as tobacco cigarettes. They may contain some harmful substances, and more research on them is needed. But Abrams says they’re much better for you than smoking.

“Up to 4 million Americans have quit or switched to using e-cigarettes,” Abrams says. “Increasing science shows they work.”

Other Lifestyle Changes Help You Quit

Find activities that make you feel as good as cigarettes did, such as exercise. “I encourage all of my patients to exercise,” Benowitz says. “For sure, it can make you less interested in smoking again and improve heart health.” Especially if you have CAD, don’t push yourself too fast. Slowly increase exercise and listen to your body, Benowitz says.

Instead of a smoke break, try chewing on fresh fruits and vegetables, says Abrams. Sugar-free candies and chewing gum can reduce stress, too.

Some people quit smoking through meditation. “If you don’t find alternative ways to keep your brain happy, you’re going to have a relapse,” Abrams says.

Get Support

The best plan may be to combine the treatments and changes above with working with an expert, called a “smoking cessation counselor.”

Friends can help, too. “Pick people you trust, who you can share your weaknesses with, if you’re struggling to quit,” Abrams says.

If someone you live with smokes, turn quitting into a joint project. “Get everyone in your house to stop at the same time,” Abrams suggests.

More ideas that are backed by research include calling “quit lines” such as 800-QUIT-NOW (800-784-8669) and joining support groups with others trying to quit.

Even hypnosis or acupuncture could be worth a try. Some studies show they can work, maybe because “in a few cases, a type of placebo effect is real,” Abrams says.

Finally, keep a journal to track what’s working and what isn’t. Take note of situations and people that make you want to smoke. Common triggers are drinking alcohol or anything that causes strong emotions. Write down what tripped you up and how you’ll avoid that next time.

There’s no magic bullet. Quitting is tough. “You’re not weak if you’re addicted,” Abrams says. “Try, try again until you figure out how to quit. Don’t ever give up.”

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