Tobacco use and second-hand smoke exposure are responsible for 1.9 million avoidable deaths from coronary heart disease, or CHD, every year. That is approximately 21% of total CHD deaths. And yet, in many countries, the links between tobacco use and heart disease remain poorly understood or largely ignored. Findings from the Global Adult Tobacco Survey show that the percentage of adults who do not believe smoking causes heart attacks ranges from 5% in Egypt to 61% in China. Around the globe, consistent findings show that people more often associate the risks of smoking with cancers rather than heart disease. Yet cardiovascular diseases (CVD) remain the leading cause of tobacco-related death. This is especially true for smokers below the age of 50, who are more than twice as likely to die from a CVD, such as coronary heart disease, than from cancer due to tobacco use.

The new World Health Organization Tobacco Knowledge Summary on tobacco and coronary heart disease has been prepared with the objective to address these misperceptions directly by summarizing the current evidence on tobacco, CHD, and public health. This document, prepared jointly with the World Heart Federation and the University of Newcastle, is intended as both an informational guide and as an advocacy tool to widely include health care professionals and policymakers in the fight for tobacco control and the prevention of tobacco related diseases. It outlines the latest science, potential roadblocks to action, and proposed solutions, with examples from best practices around the world.

One of the main public health problems highlighted by this knowledge summary is the fact that tobacco smokers are more likely to experience an acute cardiovascular event at a younger age and earlier in the course of their disease than non-smokers. Just a few cigarettes a day, occasional smoking, or exposure to second-hand smoke increase the risk of heart disease, even among casual or social smokers. This leads to not only personal health problems, but also increased pressure on health systems and many more lost years of healthy life (typically measured in Disability-Adjusted Life Years), for economies.

Fortunately, the knowledge summary also looks at ways to address the deadly relationship between tobacco use and CHD. It presents compelling evidence proving that smoking cessation interventions and smoke-free legislation improve cardiovascular health and decrease cardiovascular events in a short amount of time. Not only that, but the right action can create a virtuous cycle of good health: smoke-free legislation reduces smoking-related hospital admissions for both smokers and non-smokers alike!
The information presented in this knowledge summary can support regional, national, and local initiatives for the control of tobacco products and the prevention of CHD. Through the dissemination of these cutting-edge data and a series of strong, evidence-based policy recommendations, together we can create healthier environments and smoke-free communities.

By Kelcey Armstrong-Walenczak and Michal Stoklosa, World Heart Federation