Heart pain from smoking may be due to the tendency to have angina attacks while smoking. Compared with non-smokers, the incidence of coronary heart disease in smokers increases 2-6 times, and is positively correlated with the number of cigarettes smoked per day. Oxyhemoglobin is the body’s metabolism to provide oxygen, smokers blood carboxyhemoglobin concentration of up to 10% -20%, the relative decline in oxyhemoglobin concentration, insufficient oxygenation within the arterial blood vessel wall, the synthesis of fatty acids in the subendothelial layer of the arteries increased, and the release of prostacyclin is reduced. Prostacyclin is a kind of vasodilating substance, and its reduction can cause vasoconstriction, and platelets are easy to adhere and aggregate in the arterial vascular wall, and thrombosis occurs. Smoking can also cause an increase in serum cholesterol content, accelerating the progress of atherosclerosis. These are the reasons why smoking causes atherosclerosis and coronary heart disease. In addition, nicotine contained in tobacco can act directly on the coronary artery, causing coronary artery spasm, vascular contraction, aggravating myocardial ischemia, directly induced angina.