Abstract
Background Cardiovascular disease (CVD) is one of the significant causes of death worldwide, and smoking is a major causative factor of CVD pathogenesis. Smoking rates are high in Pakistan, and the related cardiovascular risks are concerning. The purpose of this study is to compare cardiovascular risk between smokers and non-smokers in a Pakistani population, addressing an under-researched context in cardiovascular health. Methods A cross-sectional study was conducted at hospitals in Sialkot from March to July 2025. Participants: A total of 300 participants were included, using convenience sampling. Demographic, smoking status, and cardiovascular health data were obtained using a self-administered questionnaire. The INTERHEART Modifiable Risk Score (IHMRS) was employed to report cardiovascular risk. Data were analyzed using SPSS v.26, employing descriptive statistics, correlation analysis, and multiple regression models. Results Of the sample, 190 (63%) were smokers and 110 (37%) were non-smokers. IHMRS scores were significantly higher (29.95 ± 3.10) in smokers than in non-smokers (26.85 ± 2.90) (p<0.001). The cardiovascular risk factors were closely linked to the number of cigarettes smoked per day and to the duration of smoking. The history of cardiovascular disease and family history of CVD were positively correlated with smoking intensity and duration (p<0.001). Conclusion Smoking significantly contributes to an increase in cardiovascular risk in Pakistan, and the cardiovascular risks of smokers are higher. The findings highlight the importance of specific population health measures, such as smoking cessation programs, to lessen the burden of cardiovascular diseases in the population.