Smoking plays an important role in heart disease deaths. It is about 30% in USA and may be more in the poor and developing countries.

The adverse effects of nicotine include:

• Decreased oxygen in the blood, this less to the heart
• Too much of carbon monoxide
• High blood pressure
• Increased heart rate
• Blood clotting risk is increased
• Trigger of atherosclerosis, thus heart disease

Do not forget the cancer risk from tobacco. There are no healthy tobacco products.