Smoking and GERD: Effects, link, and more
Smoking can increase the risk of gastroesophageal reflux disease (GERD) and may increase the frequency and severity of symptoms. Quitting smoking may help to reduce GERD symptoms.
Smoking tobacco or e-cigarettes will likely increase acid reflux, stomach acid production, and coughing, which can all contribute to the development of gastroesophageal reflux disease (GERD).
To reduce GERD symptoms, a healthcare professional may recommend quitting smoking.
Smoking may increase the frequency of GERD symptoms. A 2025 study associated smoking e-cigarettes with a greater number of acidic refluxes than in non-smoking participants.
Smoking may also worsen GERD symptoms. A 2024 study of 403 university students found that those who smoked tobacco or vaped had higher GERD symptom scores than non-smokers. Increased frequency of vaping linked to an increase in GERD symptoms.
The study found that newer smokers experienced more severe symptoms than those who had been smoking for longer. This may be due to increased sensitivity to nicotine in new or light smokers, although further research is necessary to confirm findings. » Learn more:Vaping vs. smoking
Smoking, including inhaling secondhand smoke, can weaken the LES. The LES is a muscle that sits between the esophagus and the stomach. The esophagus is a tube running from the throat to the stomach that transports food and liquids.
The LES opens to allow food and liquids to pass from the esophagus to the stomach. It stays closed to prevent stomach contents traveling back up the esophagus. Weakening of the LES can lead to GERD.
Smoking increases the amount of acid the stomach produces, which, in addition to the weakening of the LES, increases the risk of damage to the esophagus.
According to a 2025 study, vaping may increase the risk of developing GERD. The study included 90 participants, and found vaping linked to increased acid reflux and may play a part in the development of GERD.
This may be due to the effects of e-cigarettes on the LES.
Other tobacco products may also increase the risk of GERD due to their nicotine content. Nicotine relaxes the LES, which increases reflux due to stomach acid flowing back up the esophagus.
Quitting smoking may help to improve and reduce GERD symptoms. A 2024 study found that students who quit smoking and vaping had lower GERD symptom scores than current smokers.
Quitting smoking may allow the LES to recover and regain its usual function, which can help reduce the severity and frequency of acid reflux.
An older 2016 study tested the effects of smoking cessation on GERD. After one year, 141 participants achieved smoking cessation and 50 did not.
The group of participants who quit smoking had 43.9% improvement in GERD symptoms and significantly less frequent symptoms, according to a self-report questionnaire. The group who did not quit only experienced 18.2% improvement.
If people want to quit smoking or vaping, they can speak with a healthcare professional who can help them follow a quit plan. People can also find advice and support online through resources such as smokefree.gov. » Learn moreFive ways to quit smoking
The following lifestyle changes can help improve and reduce GERD symptoms: maintain or achieve a moderate weight
avoid foods and drinks that trigger or worsen GERD symptoms, which may include: spicy, acidic, or high fat foods caffeine alcohol
use extra pillows or a soft wedge to raise the head and upper body by 6 to 8 inches when sleeping
avoid eating at least 3 hours before lying down
Managing other health issues, including asthma and diabetes, may also help reduce GERD symptoms.
Exposure to secondhand smoke can be harmful for people with GERD, as it can have similar effects to smoking. Inhaling secondhand smoke can weaken the lower esophageal sphincter, which may worsen acid reflux.
Nicotine, a key component in tobacco products, relaxes the LES and can lead to acid reflux. Research suggests exposure to nicotine from any source may harm the digestive system and increase the frequency and severity of GERD symptoms.
Some smoking cessation products, such as nicotine replacement therapy, may interact with some GERD medications.
Nicotine may interact with cimetidine (Tagamet). Cimetidine is an antacid that reduces stomach acid, which may help manage GERD symptoms. It may increase nicotine levels in the blood, which may lead to toxicity.
It is important to speak with a doctor before taking any GERD medications alongside smoking cessation products.
Smoking is a risk factor for GERD, largely due to its effects on the lower esophageal sphincter (LES). Smoking weakens the LES, which allows stomach acid to flow back up the esophagus.
Vaping, smoking other substances such as cannabis, consuming other tobacco products, and exposure to secondhand smoke may also increase the risk of GERD.
Smoking may also increase the frequency and severity of GERD symptoms. Quitting smoking can help the LES to recover, which may reduce and improve GERD symptoms.
Acid Reflux / GERD
Smoking / Quit Smoking
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