A new study from researchers at the Johns Hopkins Bloomberg School of Public Health found that people who smoked tobacco cigarettes developed heart failure at twice the rate of those who never smoked. This higher rate occurred in two major heart failure subtypes and confirms that cigarette smoking presents a significant risk factor for both.

The study is thought to be one of the first to assess smoking’s association with both heart failure subtypes: reduced ejection fraction and preserved ejection fraction.

For their study, the researchers analyzed records from a long-running study of nearly 9,500 individuals in four U.S communities. The study found that participants who had stopped smoking retained a significantly increased risk of either type of heart failure for decades after they’d stopped smoking.

The study was published online June 6in the Journal of the American College of Cardiology.

“These findings underline the importance of preventing smoking in the first place, especially among children and young adults.” says study senior author Kunihiro Matsushita, MD, PhD, associate professor in the Bloomberg School’s Department of Epidemiology. “We hope our results will encourage current smokers to quit sooner rather than later, since the harm of smoking can last for as many as three decades.”

Heart failure is a progressive condition in which the heart loses its ability to pump enough blood to meet the body’s needs. It’s one of the most common causes of disability and death in developed countries, with more than 6 million adults living with heart failure in the U.S. alone, according to the Centers for Disease Control and Prevention most recent data. Besides cigarette smoking, risk factors for heart failure include obesity, hypertension, diabetes, coronary artery disease, and advanced age.

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