Home Am I at Risk? Smoking & Vein Disease Risk

Smoking & Vein Disease Risk

A smoker is anyone who has smoked 100 cigarettes in her lifetime and currently smokes some days or every day. You may already know that smoking raises your risk of heart disease, but the damage caused by smoking is not limited to your heart. The harmful chemicals in cigarette smoke affect all the blood vessels in your body, putting you at risk for blood clots in the veins (DVT and pulmonary embolism) as well.1

More than 21 million American women smoke, and these women die on average 15 years earlier than nonsmokers.2,3 Smoking kills 174,000 American women each year.1

See also:

Smoking & Your Heart
Smoking & PAD Risk

How does smoking affect my vein disease risk?

Women who smoke are at increased risk for deep vein thrombosis (DVT) and the potentially deadly complication pulmonary embolism (PE).4

One study of 8,889 women found that DVT risk was increased by 43% in current smokers and 23% in former smokers compared with never-smokers. The more cigarettes you smoke and the longer you have been a smoker, the higher your risk.5 Smoking may be an especially strong risk factor for women. One large Danish study of more than 50,000 patients (half were women) found that smoking caused a 52% increase in DVT risk in women, compared with 32% in men.6

Smoking increases a woman’s risk of DVT even more when combined with oral contraceptives (birth control pills). In one study, women who smoked and took birth control pills were 9 times as likely to suffer a DVT as women who had neither risk factor.5

The link between cigarette smoking and chronic vein disease, including varicose veins, is not as clear. The Framingham Heart Study found that smoking was linked to varicose veins in men but not in women, while other studies have found no link for either sex.7,8

Why is smoking so harmful?

Smoking triggers changes in your blood and veins that increase your risk of blood clots. The chemicals in cigarette smoke make the blood thicker and more likely to form clots. Smoking also reduces blood flow to the arms and legs, creating slow-moving blood that is prone to clotting.

Does secondhand smoke put me at risk for blood clots in the veins?

No studies have proven a link between exposure to secondhand smoke and your risk of vein disease. However, exposure to secondhand smoke has been shown to increase a woman’s risk of heart attack and stroke.9

Can quitting smoking help prevent vein disease?

Yes. One large Danish study found that women who quit smoking had the same DVT risk as women who had never smoked.6 This may be because smoking makes your blood more likely to clot, an effect that gradually disappears after you quit.

If you have already been diagnosed with vein disease, it is not too late to benefit from quitting smoking. Women with chronic vein disease who quit smoking have a lower risk of serious complications such as leg ulcers.10

Quitting smoking can be difficult, but getting the help you need can drastically improve your chances of success. There are medications, support groups, and programs to help you stop smoking. Your doctor can also help. See our section on quitting smoking or call 1-800-QUIT-NOW for more information.


  1. US Department of Health and Human Services. Fact Sheet: Women and Tobacco. May 29, 2009; http://www.cdc.gov/tobacco/data_statistics/fact_sheets/populations/women/. Accessed January 4, 2010.
  2. Lloyd-Jones D, Adams RJ, Brown TM, et al. Heart Disease and Stroke Statistics--2010 Update. A Report From the American Heart Association. Circulation. December 17 2009.
  3. US Department of Health and Human Services. Tobacco-Related Mortality. September 16, 2009; http://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/tobacco_related_mortality/. Accessed January 4, 2010.
  4. Lindqvist PG, Epstein E, Olsson H. The relationship between lifestyle factors and venous thromboembolism among women: a report from the MISS study. Br J Haematol. Jan 2009;144(2):234-240.
  5. Pomp ER, Rosendaal FR, Doggen CJ. Smoking increases the risk of venous thrombosis and acts synergistically with oral contraceptive use. Am J Hematol. Feb 2008;83(2):97-102.
  6. Severinsen MT, Kristensen SR, Johnsen SP, Dethlefsen C, Tjonneland A, Overvad K. Smoking and venous thromboembolism: a Danish follow-up study. J Thromb Haemost. Aug 2009;7(8):1297-1303.
  7. Brand FN, Dannenberg AL, Abbott RD, Kannel WB. The epidemiology of varicose veins: the Framingham Study. Am J Prev Med. Mar-Apr 1988;4(2):96-101.
  8. Fowkes FG, Lee AJ, Evans CJ, Allan PL, Bradbury AW, Ruckley CV. Lifestyle risk factors for lower limb venous reflux in the general population: Edinburgh Vein Study. Int J Epidemiol. Aug 2001;30(4):846-852.
  9. Bonita R, Duncan J, Truelsen T, Jackson RT, Beaglehole R. Passive smoking as well as active smoking increases the risk of acute stroke. Tob Control. Summer 1999;8(2):156-160.
  10. Robertson L, Lee AJ, Gallagher K, et al. Risk factors for chronic ulceration in patients with varicose veins: a case control study. J Vasc Surg. Jun 2009;49(6):1490-1498.

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