Angina and smoking: what you need to know

Tobacco smoke makes the heart work harder, narrows blood vessels and reduces how effectively blood carries oxygen. Stopping smoking is therefore part of treating angina, alongside prescribed medicines and management of other cardiovascular risks.

Angina occurs when the heart muscle temporarily receives less oxygen-rich blood than it needs. Nicotine raises heart rate and blood pressure, while carbon monoxide reduces the oxygen available in the bloodstream. Smoking also damages artery linings and encourages artery narrowing. Together, these effects may bring on chest pressure during less activity than usual. Second-hand smoke can also strain the cardiovascular system, so a smoke-free home and car are useful goals.

Arrange a smoking-cessation discussion with a clinician or pharmacist. They can help choose behavioural support and a stop-smoking medicine that suits your heart condition and current prescriptions. Keep taking angina medicine exactly as directed; do not alter a dose to compensate for smoking or withdrawal symptoms. Identify routines linked with cigarettes, remove tobacco and lighters, and ask people around you not to smoke nearby. Record when chest discomfort occurs, what you were doing and whether your prescribed reliever worked as instructed.

Call emergency services for chest pressure or pain that is new, severe, occurs at rest, lasts longer than expected, or does not settle after following your prescribed angina action plan. Get emergency help as well if discomfort is accompanied by breathlessness, sweating, nausea, faintness, or pain spreading to an arm, jaw, back or shoulder. Do not drive yourself. A noticeable increase in the frequency or intensity of familiar attacks also needs prompt medical assessment, even if each episode settles.

Ask which stop-smoking options fit safely with your heart medicines, how to use your angina reliever, and what change in your usual pattern should trigger urgent review. You can also ask whether your blood pressure and cholesterol treatment need reassessment and how to restart physical activity without provoking symptoms.