Each cigarette you smoke causes a temporary rise in blood pressure. Smoking damages the walls of your blood vessels, leading to atherosclerosis, where fat is laid down in your arteries walls, making the arteries narrower. It also makes your blood more likely to clot and forces your heart to work harder.
Smoking a cigarette instantly raises your blood pressure and pulse. It takes about 20 minutes  following a cigarette for your blood pressure and pulse to return to normal. But are there long-term effects? It’s unclear whether cigarette smoking also leads to an increased risk of hypertension. That’s when your blood pressure is consistently high. However, repeated temporary spikes in your blood pressure may still cause damage. While we don’t fully understand the risk of hypertension from smoking, we do know that quitting smoking can improve your overall health and reduce your risk of other cardiovascular problems.

The link between smoking and blood pressure

Smoking causes a temporary rise in blood pressure. Every time you smoke, you immediately raise your blood pressure by activating your sympathetic nervous system (SNS). Your SNS controls your body’s response to danger or stress. When your SNS is activated, hormonal signals cause extra blood flow to your muscles. This causes you to feel more tense and alert. As a result, your pulse and blood pressure will rise. Smoking triggers your SNS and causes this same rise in heart rate and blood pressure. Over time, this can damage the walls of your arteries and put you at higher risk of many serious heart conditions. Smoking can also increase the risk of the buildup of fatty substances known as plaque inside your arteries. This condition is called atherosclerosis. It can lead to heart attack and stroke if left untreated. Hypertension can increase the rate of plaque buildup inside your arteries.

Smoking vs. vaping

Vaping, or the use of electronic cigarettes, has risen in popularity in the past several years. Many vape manufacturers claim that vaping is a healthier alternative to traditional cigarettes. But studies about the effects of vaping are still inconclusive.

There’s evidence that links vaping to hypertension. For instance, a 2018 study found that e-cigarettes caused a significant rise in blood pressure in people with hypertension immediately after use. A 2021 study found that e-cigarettes had a similar relationship to hypertension as regular cigarettes, but researchers stressed the need for more long-term studies.

Does smoking increase my risk of hypertension?

Researchers don’t fully understand the link between smoking and hypertension. Smoking increases the risk of many cardiovascular conditions. But the results of studies looking at the link between smoking and hypertension have been conflicting. A 2015 analysis of 141,317 people found that smokers generally had lower blood pressure than never-smokers. A 2017 study involving men who used to smoke found they had a higher risk of hypertension than current smokers. Researchers suggest this might partially be due to weight gain common in the 2 years after quitting smoking. A different 2017 study suggests this might be because the effects of smoking are long term and often don’t show up until later in life. Conversely, any negative effects of quitting smoking are temporary. While research on this topic is ongoing, we do know that smoking is linked to an increased risk of many other health conditions, including cardiovascular conditions. So, although we don’t fully understand the risk of hypertension for smokers, the health risks of smoking are clear.

What are the symptoms of hypertension?

Hypertension is often called a “silent” condition. Many people with hypertension have no symptoms at all. Additionally, the temporary high blood pressure caused by a cigarette generally goes back down within 20 minutes. This means it often isn’t spotted during a medical exam. When symptoms of high blood pressure do occur, they can include:
  • dizziness
  • headaches
  • nose bleeds
  • confusion
  • blurry or unclear vision
  • shortness of breath
  • irregular heartbeat
  • feeling as if your heart is pounding or racing
  • red or pink urine

Should people with hypertension quit smoking?

If you smoke and have high blood pressure, it’s recommended you quit smoking. A  their blood pressure, even while taking blood pressure medication. Keep in mind that smoking causes your blood pressure to temporarily rise every time you smoke. A 2005 study even showed that cigarettes could weaken the effects of blood pressure medications, like amlodipine. Hypertension is a risk factor for cardiovascular disease. Researchers in a 2021 study observed a lower risk of cardiovascular disease for people who reduced their smoking.
How can I prevent hypertension if I smoke?
Quitting smoking is one of the best ways to lower your risk of various cardiovascular conditions. Other steps you can take to lower your blood pressure include:
  • maintaining a moderate weight
  • getting regular exercise
  • limiting the amount of alcohol you drink
  • eating a nutritious, balanced diet that is low in salt
  • taking any blood pressure medications your doctor has prescribed to you
  • taking steps to manage and limit stress

Frequently asked questions

You can find out more about smoking and high blood pressure by reading the answers to some common questions below.

Does secondhand smoke increase your blood pressure?

Yes. Exposure to secondhand smoke in the home or workplace causes a rise in blood pressure. A 2019 study found that people exposed to secondhand smoke might also have an increased risk of hypertension. How much does smoking raise your blood pressure, and for how long? A surgeon general’s report from 2010 suggests that nicotine use in any form can raise blood pressure by as much as 5 to 10 millimeters of mercury (mm Hg) immediately after use. The spike lasts for about 20 minutes. Why is my blood pressure high after quitting smoking? Some studies have found higher blood pressure readings in former smokers. This might be due to temporary weight gain and other body adjustments after quitting smoking. Many people quitting smoking also experience anxiety symptoms during nicotine withdrawal, which can easily cause elevated blood pressure during that period. However, the overall health benefits of quitting smoking are far greater than temporary increases in weight or blood pressure. You can talk with a medical professional about any health concerns you have after quitting smoking. Can you smoke cigarettes while taking blood pressure medication? Talk with your doctor about smoking and taking blood pressure medication. Some research has shown that smoking can weaken the effects of certain blood pressure medications. You might need a higher dose or a different medication. Your doctor might also talk with you about starting a program that can help you quit smoking.

Do smoking cessation drugs cause high blood pressure?

A 2016 study on the effect of smoking cessation medications on blood pressure looked for the answer to this question. Researchers found that smoking cessation products did not increase blood pressure. This was true even among study participants who already had hypertension.

Help to quit smoking

Quitting smoking is a great way to make a commitment to yourself. It’s also a serious challenge, so it’s important to have support.


Smoking causes a temporary rise in blood pressure. It activates your sympathetic nervous system and causes your pulse and blood pressure to rise for 15 to 20 minutes. At this time, it’s unclear whether smoking also increases your risk of hypertension. But smoking does increase the risk of many other health conditions, including heart conditions. If you already have hypertension, quitting smoking can help you manage your blood pressure better. You may see an increase in blood pressure in the short term due to some of the side effects of quitting smoking. But the long-term benefits of quitting are clear.