Cigarette smoking is one of the most important health concerns worldwide. Even though the
rate of smoking is declining in developed countries, it is still experiencing growth in developing regions.
Many studies have examined the relationship between smoking, as an established risk factor,
and cardiovascular diseases. We provide an updated review of the underlying mechanisms of smokinginduced
cardiovascular diseases, with a focus on the relationship between smoking and oxidative
stress, particularly from the perspective of endothelial cell dysfunction. We review smoking-induced
oxidative stress as a trigger for a generalized vascular inflammation associated with cytokine release,
adhesion of inflammatory cells and, ultimately, disruption of endothelial integrity as a protective barrier
layer. We also briefly discuss the harms related to the vaping of electronic cigarettes, which many
erroneously consider as a safe alternative to smoking. We conclude that even though e-cigarette could
be a helpful device during the transition period of cigarette quitting, it is by no means a safe substitute.