I ve heard that smoking causes heart disease. I understand lung cancer is caused by mutations the genetic code of structures such as the alveoli , but I m not too clear on how smoking may contribute to heart disease. Of course, as a stimulant that taxes the heart and lungs, nicotine may not exactly be the most healthful thing affecting the cardiovascular system, but no one blames caffeine for their cardiovascular maladies. What s the deal with smokes and heart disease ?