Does Smoking Cause High Blood Pressure?

Smoking and nicotine use can immediately raise your blood pressure and may cause chronic hypertension

Michael Schroeder,

Updated July 10, 2025

AARP

Reviewed by

Merle Myerson, M.D.

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En español

Published June 03, 2024

/ Updated July 10, 2025

cigarette butts in a heart shaped tray with smoke billowing out behind the tray

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High Blood Pressure Guide

Need one more reason to quit smoking? Every time you light up, it has an immediate impact on your cardiovascular system. Even exposure to secondhand smoke can have a negative effect on cardiovascular health, just as smoking does.

The American Heart Association says smoking and secondhand smoke increase your risk for plaque buildup inside your arteries, known as atherosclerosis. High blood pressure, also called hypertension, speeds this up.

Does smoking raise blood pressure?

Research shows your blood pressure increases every time you smoke. “Studies have shown that smoking one cigarette raises a person’s heart rate and blood pressure for about 15 to 30 minutes,” says Robert Kloner, M.D., professor of medicine (clinical scholar) at the Keck School of Medicine at the University of Southern California and chief science officer and director of cardiovascular research at Huntington Medical Research Institutes in Pasadena, California. “So if you smoke frequently, that’s going to occur more commonly throughout the day.”

Smoking can also lead to physical changes like stiffening of the arteries and atherosclerosis, which are risk factors for heart attacks and strokes, Kloner says.

“There’s no question smoking is very bad for the cardiovascular system,” he emphasizes, “and the best advice is not to smoke.”

How much does smoking raise blood pressure?

It’s difficult to put a number on how much smoking raises blood pressure, because it’s so variable. But a study published in the Journal of Hypertension found that smoking two cigarettes per hour could raise daytime blood pressure by 5 to 6 millimeters of mercury (mm Hg); and experts say that even a relatively small rise in blood pressure can have a significant effect on cardiovascular health.

A consistent blood pressure above normal (120/80 mm Hg) is considered elevated. The top number — systolic blood pressure — measures the pressure in your arteries when your heart contracts and pumps blood out to your body through the arteries. The bottom number — diastolic blood pressure — measures the pressure in your arteries as your heart is relaxing between beats and blood is returning to the heart through the veins.

If we wait until your blood pressure is 140/90 versus a normal blood pressure of 120/80, “we’ve already doubled the risk for heart attacks and strokes,” says Keith Ferdinand, M.D., professor of medicine and the Gerald S. Berenson endowed chair in preventive cardiology at Tulane Heart and Vascular Institute in New Orleans. Even at that lower threshold, many people whose blood pressure rises when they smoke don’t notice — but they aren’t out of harm’s way.

Smoking and masked hypertension

Lighting up doesn’t just immediately raise your blood pressure. It also causes a condition known as masked hypertension, which is when your blood pressure readings at the doctor’s office are normal, but outside of that, your blood pressure is high.

Studies from the American Heart Association found that people who smoke are more likely to have masked hypertension. And research suggests that having masked hypertension can increase your risk of organ damage, cardiovascular disease and kidney disease.

Is smoking a risk for hypertension?

Yes. Smoking and exposure to secondhand smoke increase your risk for high blood pressure, according to the American Heart Association. Even if smoking doesn’t chronically raise your blood pressure, Ferdinand says it can damage your artery walls, which can lead to plaque buildup. If that plaque breaks off or creates a blockage, it can cause a heart attack or stroke.

Smoking also damages and narrows your blood vessels and hardens your arteries, which can affect your blood pressure and cardiovascular health.

Does nicotine raise blood pressure?

Nicotine, the addictive chemical in cigarettes, can have “dramatic effects,” says Lawrence Sinoway, M.D., cardiologist and professor of medicine at Penn State College of Medicine. These effects include increasing your heart rate and the blood flow to your heart, and the hardening and narrowing of your arteries, so more blood has to flow through a tighter area, increasing your blood pressure. Nicotine can also stay in your body up to eight hours after you smoke.

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Does vaping cause high blood pressure?

E-cigarettes that contain nicotine and flavoring agents have been on the market for less than two decades, so there isn’t much long-term research on how vaping affects cardiovascular health.

But in 2023, the American Heart Association released a statement identifying health risks of e-cigarettes, including high blood pressure.

In results presented at the 2022 AHA scientific meeting, researchers from the Cardiac and LUng E-cig Smoking (CLUES) Study found that people who vaped had a rise in their systolic and diastolic pressures immediately afterward, similar to those who smoked cigarettes.

Does Smoking Weed Cause High Blood Pressure?

Most Americans now live in a state where they have access to legal medical marijuana. And research from the New York University School of Global Health says that more adults over 65 are smoking marijuana than ever before, particularly to help with chronic health conditions.

Research proving an association between smoking marijuana and high blood pressure, however, are inconsistent. A study published in the Journal of Hypertension found that nearly 1,000 study participants (ages 35 to 59) who had smoked weed monthly for more than a year were not at higher risk of increased blood pressure than other adults.

While not all studies have shown the association, most clinical studies have provided information showing that cannabis and related products have adverse consequences for cardiovascular health.

For instance, researchers at the American Heart Association found that marijuana users were 25 percent more likely to have a heart attack and 42 percent more likely to have a stroke than people who didn’t smoke weed. Results could vary in older adults.

Marijuana contains hundreds of compounds called cannabinoids, including cannabidiol (CBD) and the psychoactive component tetrahydrocannabinol (THC).

THC in today’s marijuana is exponentially higher than ever before, and when regulation is lacking, it becomes harder know how it can affect blood pressure. “The more THC, the worse,” Kloner says.

“Smoke is smoke,” Ferdinand says. The combustion when you smoke weed can expose you to things like carbon monoxide, just like smoking a cigarette does.

A separate meta-analysis and systematic review of research on the effects of vaping on the cardiovascular system published in the journal Cureus in 2023 also found that people who smoked e-cigarettes were more likely to see a rise in blood pressure.

So trying to quit smoking by substituting cigarettes with e-cigarettes may not be the best idea, since both contribute to cardiovascular problems, including high blood pressure. The safest way to kick the habit is to talk to your doctor and get the help you need.

“If you stop smoking, you can increase life expectancy by up to 10 years,” Sinoway says, “and your risks of heart disease and lung disease and cancer decline.”

How to Quit Smoking

Having ample reasons to quit smoking — including knowing that smoking can cause your blood pressure to rise — doesn’t make it easy to kick the habit.

“Smoking cessation is difficult,” Ferdinand says, but it’s still possible to break the addiction, no matter how many times you may have tried.

Follow these tips for success:

Put past failures behind you. Instead of dwelling on relapses, which are normal, try new approaches to quitting.
Set a quit date. The Centers for Disease Control says to pick a day within the next two weeks to give yourself time to prepare for the change, so it’s not so far out that you lose motivation. Avoid choosing a stressful time, if you can.
Be careful with e-cigarettes. Many who start vaping in hopes of quitting smoking end up doing both, researchers at the Washington University School of Medicine in St. Louis found.
Try quit-smoking aids. Discuss with your doctor all options to stop smoking, including nicotine patches, gum and lozenges.
Expect positive results. Quitting smoking not only improves heart and lung health, it’s a boon for mental health, too. Research finds people who quit smoking have lower rates of anxiety and depression and often see improvements in mood.

Editor’s note: This story, originally published June 3, 2023, has been updated to reflect new information and new reporting from Sarah Gleim.

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Michael Schroeder is a freelance health writer and editor who’s covered everything from chronic disease and mental health to medication side effects. His stories have been published in a range of print and digital publications, including Outside Magazine, Time, U.S. News & World Report, The Washington Post and Psychology Today.

Dr. Merle Myerson is a board-certified cardiologist with specialties in sports medicine, lipids, women’s health and prevention of cardiovascular disease.