The detrimental effects of cigarette smoking were widely advertised in the mid-1970s, and since then more than 20 million North Americans have stopped smoking. Smoking has increased in teenagers and women, however, resulting in little change in the overall number of smokers. Heart attacks are rare in women aged, 40–48, but in women of this age who use oral contraceptives and smoke, the heart attack rate is increased. Over the past two decades cigarette smoking has increased considerably in Japan, China, India, Russia, its former territories, and the developing world. Cardiovascular events are on the increase in these countries.
Low-nicotine, low-tar brands, or filter cigarettes do not decrease the risk of coronary heart disease, although the risk of lung cancer may be decreased. Filter cigarettes deliver more carbon monoxide and cause a higher inci¬dence of coronary heart disease than do plain cigarettes.

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• I. EFFECTS OF COMPONENTS OF CIGARETTE SMOKE
  Tobacco smoke contains more than 4000 components. Some of these are nicotine, carbon monoxide, ammonia, benzene, nitrobenzene, phenol, 2,4,dimethylphenol, acet-aldehyde, hydrogen cyanide, toluene and O-cresol. Most studies have been done on nicotine and various gases, in particular, carbon monoxide (CO).
• II. CIGARETTE SMOKE AND ATHEROSCLEROSIS
  A. Nitric Oxide and Vasodilatory Function
• III. RECENT EPIDEMIOLOGIC STUDY
  In the recently published INTERHEART study reported by Yusuf et al.: ‘‘risk factors were significantly ( p < 0.0001) related to acute myocardial infarction, except alcohol, which had a weaker association ( p ¼ 0.03). After multi-variate analysis, current smoking and raised ApoB/ApoA1 ratio (top vs. lowest quintile) were the two strongest risk factors, followed by history of diabetes, hypertension, and psychosocial factors. Body-mass index was related to risk of myocardial infarction, but this relation was weaker than that of abdominal obesity (waist/hip ratio).’’
• IV. ANGINAL CHEST PAIN AND IMPOTENCE
  A. Anginal Pain
• V. HABITUATION AND CESSATION
  A. Habituation
• BIBLIOGRAPHY
  Adams, M. R., Jessup, W., and Celermajer, D. S. Cigarette smoking is associated with increased human monocyte adhesion to endothelial cells: Reversibility with oral L-arginine but not vitamin C. J. Am. Coll. Cardiol., 29:491–497, 1997.