How Does Smoking Affect a Smoker’s Feet?

In short, yes, smoking can affect your feet and legs by reducing blood flow and slowing bone growth. Broadly termed “smoker’s feet,” smoking can actually lead to a variety of different foot and leg conditions.

Tobacco products contain nicotine, a highly addictive chemical substance. One effect that nicotine has within the body is vasoconstriction, or narrowing, of blood vessels, making it much harder for your heart to pump blood throughout your whole body. This can lead to slowed blood flow and can cut off circulation to different body parts.

Since your hands and feet are the farthest away from your heart with the smallest blood vessels, they’re often the most affected. Reduced or cut-off circulation can lead to:

• blood clots
• slower healing of wounds
• decreased sensation in your feet
• nerve damage
• tissue death

There are several conditions of the feet and legs that may be caused by smoking. Read on to learn more.

Peripheral arterial disease (PAD)

Peripheral arterial disease (PAD) is the condition that most people think of when they say “smoker’s feet.” It develops when plaque (fatty deposits) clogs your arteries and limits blood flow to your limbs. This leads to a limited ability to walk due to painful legs or feet, and it greatly increases your chances of having a stroke or heart attack.

PAD is fairly common, a recent report showed that one in every 20 people in the United States over the age of 50 has PAD. Smoking is one of the biggest risk factors for developing PAD.

Symptoms include:

• fatigue, heaviness, or weakness in the legs or feet
• pain in the legs or feet
• open sores or wounds on toes, feet, and legs that heal slowly or not at all
• color changes or persistent coldness in the feet or legs
• poor nail and hair growth

Buerger’s disease

Buerger’s disease, also known as thromboangiitis obliterans, is an inflammatory disease that causes blood clot formation within blood vessels. These clots can prevent blood flow, most commonly to your extremities, such as fingers and toes.

This lack of blood flow to your feet and hands can lead to pain, tissue damage, or even gangrene — the death and decay of body tissues due to lack of oxygen and nutrients. In some cases, gangrene can lead to amputation.

The risk of developing Buerger’s disease greatly increases when you smoke heavily. The best treatment is to stop smoking.

The most common symptoms of Buerger’s disease are:

• pale, red, or bluish fingers and toes
• cold hands or feet
• pain or tingling in the hands, legs, and feet
• small painful sores on the fingers or toes, or inflamed veins

Osteoporosis

Osteoporosis is a condition where your bones break down faster than they regrow. Smoking has been shown to slow bone growth, which may lead to osteoporosis and an increased risk of breaking or fracturing bones.

The most common signs that you may be developing osteoporosis include:

• receding gums
• weakened grip strength
• brittle fingernails
• increase in fractures or breaks from falls
• stooped posture
• getting shorter over time

Smoking slows bone growth and creates inflammation in your arteries that can reduce blood supply. For this reason, studies have shown that it takes longer for bone fractures or breaks to heal if you smoke.

Raynaud’s syndrome

Raynaud’s syndrome is a condition where blood flow to your fingers, toes, ears, or nose is interrupted or restricted. Raynaud’s is typically associated with triggers, the most common being cold temperature. Since smoking affects blood flow through small blood vessels, it’s a major risk factor for the development of Raynaud’s syndrome.

If you have Raynaud’s syndrome, you may experience:

• cold, numb, pale, fingers or toes, particularly after exposure to the cold
• when circulation recovers, redness, swelling, or discomfort in the same regions
• in severe cases, you can develop skin ulcers or tissue death

Plantar calluses

Plantar calluses are thick calluses that form on the bottoms of your feet. This is a very common condition and is easily treated.

There’s evidence that smoking can lead to more calluses on your feet due to the restriction of blood flow.

All of these conditions can be caused or worsened by heavy smoking. If you feel you may have or may be developing any of these conditions, talk with your doctor.

The main ways that smoking may affect your foot health is by reducing blood flow to your extremities and slowing bone growth and healing.

Smoking limits blood flow through your arteries and veins in two main ways:

• First, many tobacco products contain the highly addictive chemical nicotine. Nicotine has been shown to constrict your blood vessels, making them narrower, limiting the amount of blood they can carry and decreasing blood flow. Over time, this can also make them more rigid, causing the heart to work harder to circulate blood.

• Second, the chemicals in cigarettes can weaken the cells on the inside of blood vessels, making it easier for fatty deposits called plaque to build up and further restrict blood flow.

Smoking has also been shown to slow and hinder bone growth. This means that if you’re a heavy smoker, you’re more likely to have weaker bones, which can lead to more frequent fractures and breaks with a longer healing time.

Diagnosis varies with each condition affecting the feet. If you’re a smoker and are concerned that you may be developing a foot condition, begin by talking with your primary healthcare professional or a podiatrist (a doctor specializing in the care of feet).

In many cases, there’s no specific test to help diagnose these conditions. Your doctor may order blood tests to rule out other conditions, and perform comparative blood pressure exams on your arms and legs.

They may order imaging, such as an angiogram, a scan that visualizes your arteries, or an ultrasound of your veins.

In all cases, the first step is talking with a healthcare professional.

The best thing you can do to stop or slow any of these conditions is to quit smoking.

Treatment varies for each condition, but in most cases, there’s no cure. Your healthcare professional may recommend the following to help relieve symptoms:

• exercise
• eating a balanced diet
• keeping your feet warm in cold weather
• taking calcium supplements

You can also take steps to lower your cholesterol and blood pressure with medication.

There are additional risk factors for certain conditions of the feet if you smoke. While they vary between each condition, there are a few additional factors that can lead to conditions like peripheral arterial disease (PAD), Buerger’s disease, as well as increased risk of developing blood clots:

• diabetes
• high cholesterol
• high blood pressure
• genetics
• age
• sex

According to the National Institutes of Health, research shows that PAD occurs more frequently among Black people than white people. One reason for this may be inequities in healthcare.

Those assigned female at birth are more likely to develop osteoporosis than those assigned male. The CDC found that the age-adjusted prevalence of osteoporosis was higher among women (19.6%) compared with men (4.4%).

The outlook for these conditions of the feet varies based on which condition you’re experiencing. In extreme, untreated cases of conditions like Buerger’s disease, you may experience tissue death, or gangrene, which can sometimes lead to amputation.

A concern for developing PAD is the major increase in the risk of heart attacks and stroke.

However, for many of these conditions, symptoms have been shown to decrease once you stop smoking.

Can using e-cigarettes and vapes also hurt my feet?

Yes, the chemical nicotine is responsible for many of the conditions listed above. If you’re using a vape or e-cigarette that contains nicotine or other harmful chemicals, you’re at risk for developing these conditions.

How long does it take for blood circulation to improve after quitting smoking?

Blood circulation has been shown to improve anywhere from 6 to 12 weeks after quitting smoking. This should help lead to healthier feet and legs.

Does gangrene always lead to amputation?

If it’s caught early on, gangrene (or tissue death) doesn’t always end in amputation. However, if left untreated or if the infection is beginning to spread, amputation may be necessary in order to save your life.

Smoking negatively affects every aspect of your health, and your feet and legs are no exception.

There are a variety of foot and leg conditions that you can develop from smoking, ranging in severity from increased risk of calluses on your feet, to increased risk of bone fractures, to tissue death and amputation.

The number one thing you can do for your foot, leg, and all-around health is to quit smoking.