Tobacco and Peripheral Vascular Disease

Cigarettes cause peripheral vascular disease, a condition that reduces blood flow to the limbs and which can lead to gangrene and limb amputation.Footnote 1Footnote 2

Key facts about tobacco use and peripheral vascular disease

View health-related messages for all tobacco product packaging.

What is peripheral vascular disease?

Peripheral vascular disease is the reduction of blood flow to arms and legs due to narrowed blood vessels. This is caused by atherosclerosis, a condition that leads to the narrowing of the arteries through plaque buildup.Footnote 5

Peripheral vascular disease is often undiagnosed because symptoms can be mistaken for normal signs of aging. Symptoms of the disease include leg pain that does not go away, foot or toe wounds that heal slowly, poor toenail growth, and low foot or leg temperature.Footnote 6

If detected early, peripheral vascular disease can be treated through lifestyle modification and medication. At later stages, surgery to the blood vessels (such as a bypass graft) in the affected limbs may be required.Footnote 7

If left untreated, peripheral arterial disease can lead to gangrene, the death of body tissue, which can lead to limb amputation. If someone who smokes also has diabetes, they are up to four times more likely to lose a limb.Footnote 8

How does tobacco use increase the risk of peripheral vascular disease?

Smoking contributes to the formation of blood clots in blood vessels. Smoking also promotes the build up of plaque in arteries, making them narrower. This plaque can harden and could cause the vessel to rupture, leading to the formation of blood clots.Footnote 1Footnote 9

Smoking contributes to poor blood vessel function in both coronary and peripheral arteries.Footnote 10

How does quitting reduce the risk of peripheral vascular disease?

Smoking is one of the biggest risk factors for peripheral vascular disease development and progression.Footnote 11

Quitting reduces the development of atherosclerosis and slows down the progression of atherosclerosis.Footnote 12

If surgery is required due to peripheral vascular disease development, quitting at the time of surgery still improves rates of success.Footnote 4

If someone who smokes has peripheral vascular disease, quitting can help lower risk of limb amputation.Footnote 11

Health benefits of quitting tobacco use at any age

Quitting tobacco use reduces the risk of premature death, improves health, and enhances quality of life.Footnote 12 Quitting at any age is beneficial to one's health.Footnote 12 Even people who have smoked or used tobacco heavily for many years benefit from it.Footnote 9Footnote 12 Quitting is the most important thing someone who smokes can do to improve their health.

Read more about the benefits of quitting smoking.

Call for free help to quit

Call the toll-free pan-Canadian quit line at 1-866-366-3667. Quit line counselling, alone or in combination with cessation medication, increases success in quitting.Footnote 12

Footnotes

Footnote 1

U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2014.

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Footnote 2

Lu L, Mackay D, Pell J. Meta-analysis of the association between cigarette smoking and peripheral arterial disease. Heart. 2014;100:414-423. http://dx.doi.org/10.1136/heartjnl-2013-304082

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Footnote 3

Norgren L, Hiatt W, Dormandy J et al. Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II). J Vasc Surg. 2007;45 Suppl S:S5-67. doi:10.1016/j.jvs.2006.12.037.

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Footnote 4

Willigendael E, Teijink J, Bartelink ML et al. Smoking and the patency of lower extremity bypass grafts: A meta-analysis. J Vasc Surg. 2005;42(1):67-74. doi:10.1016/j.jvs.2005.03.024.

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Footnote 5

American Heart Association. About Peripheral Artery Disease (PAD). Updated June 2, 2021. Accessed May 2, 2022. https://www.heart.org/en/health-topics/peripheral-artery-disease/about-peripheral-artery-disease-pad

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Footnote 6

American Heart Association. Symptoms and Diagnosis of PAD. Updated June 2, 2021. Accessed May 2, 2022. https://www.heart.org/en/health-topics/peripheral-artery-disease/symptoms-and-diagnosis-of-pad

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Footnote 7

American Heart Association. Prevention and Treatment of PAD. Updated June 2, 2021. Accessed May 2, 2022. https://www.heart.org/en/health-topics/peripheral-artery-disease/prevention-and-treatment-of-pad

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Footnote 8

Humphries M, Brunson A, Li CS, Melnikow J, Romano P. Amputation trends for patients with lower extremity ulcers due to diabetes and peripheral artery disease using statewide data. J Vasc Surg. 2016;64(6):1747-1755.e3. https://doi.org/10.1016/j.jvs.2016.06.096

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Footnote 9

U.S. Department of Health and Human Services. The Health Consequences of Smoking. A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2004.

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Footnote 10

U.S. Department of Health and Human Services. How Tobacco Smoke Causes Disease: The Biology and Behavioral Basis for Smoking-Attributable Disease: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health; 2010.

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Footnote 11

Canadian Cardiovascular Society Consensus Conference. Peripheral Arterial Disease. 2005. Accessed May 2, 2022. https://ccs.ca/app/uploads/2020/12/PAD_CC_2005.pdf

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Footnote 12

U.S. Department of Health and Human Services. Smoking Cessation: A Report of the Surgeon General. Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health, 2020.

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