
Written by Dr Katie Stephens, GP
Dr Katie graduated from the University of Manchester in 2007 (MBChB) and completed her GP training in the West Midlands in 2012 (MRCGP).

Where’s the proof?
We’ve all heard that smoking is bad for us, but how so? And how can we be sure? Depending on whether you’d prefer to read a 700 page article2 that references another 84 different articles (!), or a much briefer, 20 page summary for the lay person3, the evidence is there. However, I always think it is more helpful to view it in the opposite, more positive light; instead of listing how smoking harms your health, here are some of the ways that stopping smoking can benefit you:
- Reduce your risk of 12 types of cancer4
- Slow the decline in how well your lungs work (ie stopping smoking improves lung function compared to continuing smoking)5
- Reduce your risk of heart attack and stroke1
- Add as much as 10 years to your life expectancy4
- Reduce risks associated with passive smoking to people around you6, eg risks of meningitis and chest infections in children exposed to passive smoke.
Is smoking linked to blood pressure?
We know that both smoking and blood pressure can independently increase the risk of serious conditions like heart attacks and strokes. But does smoking affect blood pressure directly? Well, it certainly causes a temporary rise in your blood pressure. Longer-term effects are still debated: some older research surprisingly suggests that smoking lowers blood pressure. If you’ve heard of these articles and used this as justification for not yet quitting, I’m afraid I have bad news: you are probably being misled.
Essentially, these articles took just a snapshot look at current behaviour and blood pressure readings and so likely have significant bias included. As the effects of smoking on the body are slow and cumulative over time, looking at someone’s health and smoking habits over many years is probably a more reliable way of assessing smoking’s actual impact. There is a fantastic study that does this exactly, with almost 30,000 participants: it found that there did indeed appear to be a link between the number of cigarettes smoked and developing high blood pressure, this link became more evident as age increased7.


How does smoking raise your blood pressure?
As a child, did you ever pop your thumb on the end of a hose pipe in order to spray water at an unsuspecting sibling or friend? Narrowing the space for the water to come out the end of the pipe increases the pressure it is under, and so means you can spray it further and harder. This is probably a bit like how smoking can raise your blood pressure: if you imagine your blood vessel (or artery) is the pipe, smoking can narrow it down and make it more firm through a process called atherosclerosis (essentially depositing fatty gunk on the inner aspect of the artery walls). The blood coming through the narrowed artery is then under more pressure, which is another way of saying the blood pressure is raised.
What is the problem with having high blood pressure?
Why should we care about our blood pressure being raised? In a nutshell, it increases our risk of more serious things like strokes & heart attacks and can damage various organs in our body.
Withdrawal Symptoms
Depending on how much you are smoking at the moment, you may expect to get withdrawal symptoms. Briefly, these may include craving cigarettes, feeling irritable, brain fog and increased appetite. Being prepared for these with a plan of action is always helpful and there is a great resource here8 that has practical ways to manage the seven most common withdrawal symptoms.

Where to go for support
If I’ve managed to convince you with my hose pipe analogies and multiple evidence-rich references that now really is the right time to move from the contemplation stage to taking action, then please comment below and let me know, as I would love to hear about this. I highly recommend visiting the NHS Stoptober site1 for advice and support. Consider downloading the free NHS Quit Smoking app to get yourself set up with some good support. You can also find local support by popping your postcode in on this9 page.
Lastly, if you have concerns about your blood pressure, please have a look at our monitors below, which are all BIHS-approved and reliable.
Dr Katie Stephens, GP
Dr Katie graduated from the University of Manchester in 2007 (MBChB) and completed her GP training in the West Midlands in 2012 (MRCGP).
References
- https://www.nhs.uk/better-health/quit-smoking/
- https://www.hhs.gov/sites/default/files/2020-cessation-sgr-full-report.pdf
- https://www.hhs.gov/sites/default/files/2020-cessation-sgr-consumer-guide.pdf
- https://www.cdc.gov/tobacco/quit_smoking/how_to_quit/benefits/index.htm
- https://www.brit-thoracic.org.uk/quality-improvement/clinical-resources/smoking-cessation/
- https://www.nhs.uk/common-health-questions/lifestyle/what-are-the-health-risks-of-smoking/
- Gao K, Shi X, Wang W. The life-course impact of smoking on hypertension, myocardial infarction and respiratory diseases. Sci Rep. 2017;7(1):4330. doi:10.1038/s41598-017-04552-5: https://www.nature.com/articles/s41598-017-04552-5
- https://www.cdc.gov/tobacco/campaign/tips/quit-smoking/7-common-withdrawal-symptoms/index.html
- https://www.nhs.uk/better-health/quit-smoking/find-your-local-stop-smoking-service/