Smoking linked to artery disease in women

BMJ Group News

What do we know already?

Smoking causes several serious health problems, including lung cancer, heart disease, and stroke. Some studies suggest that smoking may also increase the risk of peripheral arterial disease (PAD), although not much research has been done on this.

If you have PAD, your large arteries - usually in your legs - become too narrow. Not enough blood gets through, causing cells to die. This can result in an aching pain, numbness, and tingling. If your leg gets badly damaged, there's a small risk it will need to be amputated.

Previous studies linking PAD to smoking have been relatively small and included more men than women. They also haven't explored whether stopping smoking might lower the risk of this disease.

To learn more, researchers followed nearly 40,000 women aged 45 and older for 13 years. At the start of the study, and every year after, the women completed questionnaires asking about their health and smoking habits. They were also asked whether they had any symptoms of PAD.

What does the new study say?

Women who smoked 15 or more cigarettes a day were 10 times more likely to get symptoms of PAD than women who never smoked. But the risk was much lower among women who quit smoking. They had only three times the risk of a lifelong non-smoker.

The researchers also found that a woman's risk climbed higher the more cigarettes she smoked a day and the longer she'd been smoking. And, conversely, her risk dropped lower as more time passed after giving up cigarettes.

The link between smoking and PAD remained strong even after the researchers took into account other things that could have affected the women's risk, such as their age, their body mass index (BMI), how active they were, how much alcohol they drank, and whether they had high blood pressure or diabetes.

How reliable is the research?

This was a large study that followed women for several years, and its findings should be fairly reliable.

However, the study may have underestimated how many women had PAD, as it wasn't designed to spot women with an early stage of the disease and no symptoms.

Also, this type of study can't prove cause and effect. So, although the study found a strong link between smoking and PAD, we can't yet be certain that smoking caused the condition.

We also don't know if these findings apply to men, although a connection seems likely.

Where does the study come from?

Researchers in the US, Switzerland, and France collaborated on the study, which was published in the Annals of Internal Medicine, a journal owned by the American College of Physicians. The study was funded by the US National Heart, Lung, and Blood Institute, and the US National Cancer Institute.

What does this mean for me?

If you're a woman and smoke, there are many compelling reasons for quitting, including a lower risk of cancer, heart disease, and lung problems. This study suggests another incentive: a lower risk of PAD.

What should I do now?

Stopping smoking isn't easy. But there are treatments that can help, including nicotine patches and other types of nicotine replacement, counselling, and medicines. Talk to your GP about what might be best for you.

The NHS also offers a smoking helpline, which smokers and their families can call for free advice. The number is 0800 022 4332.