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Circ J. 2019 Sep 25;83(10):1980-1985. doi: 10.1253/circj.CJ-19-0323. Epub 2019 Aug 29.

Effects of Tobacco Smoking on Cardiovascular Disease.

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Department of Advanced Medicine in Cardiopulmonary Disease, Nagoya University Graduate School of Medicine.
Department of Cardiology, Nagoya University Graduate School of Medicine.


Tobacco smoking continues to be a major risk factor for cardiovascular disease (CVD) and the leading avoidable cause of death worldwide. Tobacco smoking has declined in high-income countries, but the average smoking rate in Japan remains high: 29.4% for men and 7.2% for women in 2017. Of note, the average smoking rate among middle-aged men remains approximately 40%, indicating that a high incidence of smoking-related CVD will continue for a couple of decades in Japan. The adverse effects of tobacco smoking on CVD are more extensive than previously thought. Physicians should be particularly alert to the development and progression of heart failure, atrial fibrillation, and venous thromboembolism, as well as ischemic CVD among tobacco smokers. Increasing use of heat-not-burn tobacco as cigarette alternatives is an emerging issue. Harmful effects do not disappear just by changing the delivery system of tobacco.


Atrial fibrillation; Cardiovascular disease; Heart failure; Tobacco smoking; Venous thromboembolism

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