Smoking and inflammation: Their synergistic roles in chronic disease

Cigarette smoking is a major risk factor for the development and progression of cardiovascular and other chronic diseases. Cigarette smoke increases inflammatory mediators in the circulation and generates high amounts of reactive oxygen species, which are potent triggers of the inflammatory response and thought to play a central role in the development of atherosclerosis. Low-grade inflammation, atherogenic lipoprotein profile, and hypercoagulability are characteristic of smokers, and smoking cessation has been associated with a rapid improvement in the inflammatory balance. In individuals with high risk of coronary disease, 1 year of smoking cessation significantly counteracts impaired endothelial function, as assessed by a decreased plasma level of intercellular adhesion molecule. This review focuses on the connection between smoking and inflammation and their role in chronic disease.