Source: Medical Cardiovascular Channel Although smoking is a major cause of human disease and death, tobacco remains one of the world’s most popular commodities. China is the largest producer and distributor of tobacco, and cigarettes, like opium, are eroding people’s health and economic wealth, and will deeply affect the next generation. In everyday activities, when someone “toast” the cigarette, people often answer: thank you. But smoking kills as many as 5 million people each year – as many as tuberculosis, AIDS and malaria combined. By 2030, this number is expected to rise to 8 million per year. If effective measures are not taken, one billion people will die from smoking in this century. According to foreign data, the top three diseases causing death by smoking are chronic obstructive pulmonary disease (COPD), coronary heart disease and lung cancer, in order, while in China it is COPD, lung cancer and coronary heart disease. Most of the damage to health from smoking takes years or even decades to become apparent. So, for the new smokers who have increased in recent years, the damage caused by smoking is just beginning now. However, smoking is one of the most preventable causes of death in the world today, and quitting smoking can reduce the risk of cardiovascular death by 36%. Smoking and Coronary Heart Disease Smoking is second only to advanced age in its importance for coronary heart disease. a series of studies over 50 years have confirmed that smoking more than 20 cigarettes a day increases the risk of coronary heart disease by 2-3 times. In the United States, 35-40% of smoking-related deaths are due to ischemic heart disease, and an additional 8% are from passive smoking. And, as mentioned earlier, smoking is also one of the most preventable risk factors for coronary heart disease. Data from our study suggest that smoking is an independent risk factor for acute coronary events, with smokers having 1.75 times the risk of acute coronary events compared to nonsmokers. 31.9% of ischemic cardiovascular disease in people aged 35-59 years in China is associated with smoking. The mechanisms by which smoking increases the risk of coronary heart disease may include several aspects, including: 1, vascular endothelial dysfunction: some studies have shown that smoking reduces nitric oxide biosynthesis, which affects the diastolic function of the vascular endothelium; 2, promoting thrombosis: smoking promotes platelet aggregation, and in addition, tissue factor activity is significantly higher in smoking patients than in nonsmokers, and tissue factor plays an important role in the process of thrombosis 3, increased inflammatory response: some smokers may have elevated white blood cell counts and other inflammatory indicators; 4, increased oxidative modifications: smoking can promote the peroxidation of lipids in the body, contributing to the progression of atheromatous plaques. Smoking and atherosclerosis The close relationship between smoking and lung cancer is known to most people today, but not enough attention has been paid to the link between smoking and cardiovascular disease. Many patients with myocardial infarction and stent implantation are still unable to quit smoking completely. Prospective follow-up autopsy studies and retrospective smoking survey autopsy studies have shown that smoking is quite closely associated with atherosclerosis. Smoking promotes the formation and exacerbation of atheromatous plaques in the arterial wall. The relationship between smoking and damage to small arteries within the myocardium has been studied and found to be closely related to smoking in terms of arterial wall lesions, fibrotic thickening, atherosclerosis, calcification, and glassy thickening.