Tobacco-Related Cardiovascular Diseases in the 21st Century

Cigarette smoking activates platelets, induces endothelial inflammation, and promotes vascular dysfunction leading to accelerated atherosclerosis, plaque rupture, acute coronary syndromes, and death. Over several decades, notable advances in public policy in the United States have reduced initiation and increased cessation of cigarette smoking, thus lowering the prevalence of tobacco product consumption and related cardiovascular disease (CVD). Indeed, most people in developed countries understand the harm of cigarette smoking and the health and economic benefits of abstinence and cessation. However, these public health successes have slowed recently,1 reflecting perhaps a higher degree of addiction in remaining smokers and also a degree of fatigue in further advancing preventive and treatment strategies, as well as scientific knowledge more generally.Several realities underscore the current challenges …