Cardiovascular disease (CVD) or heart disease is a major cause of death worldwide. Approximately 17.3 million people died from heart disease in 2008, and more than 23 million people will die from heart disease by 2030 (WHO, 2014). The causes of heart disease vary due to many risk factors. Tobacco use is a major risk factor for heart disease. The increasing magnitude of global heart disease mortality and morbidity rates urgently requires public attention and global responses to tobacco use. Most importantly, smoking is a preventable risk factor for cardiovascular disease. The burden of cardiovascular disease has been the primary reason for many studies and research aimed at improving interventions for smoking and heart disease prevention. Evidence from biological links, environment and age has shown various lines of evidence that smoking is linked to the origin of heart disease. In addition to cultural attitudes toward smoking, nicotine dependence, gender, and economic costs of prevention and control globally reflect the challenges of smoking cessation in different countries.1) Heart disease appear to be the leading cause of death in both developed and developing countries (WHO). , 2011); however, the mortality rate varies considerably between countries. Studies have shown that deaths from heart disease occurring in developing countries account for 75% of global deaths (Gaziano, 2010). By examining statistical data on general trends in cardiovascular disease. This evidence suggests that a country with a high smoking prevalence faces considerable risks of heart disease-related morbidity and mortality in the population. For example, in a...... middle of article ...... inverse relationship between the plasma level of high-density lipoprotein (HDL), which is the level of good cholesterol, and the risk of developing heart disease, which means a higher rate. the HDL in plasma, the lower the risk of heart disease (He, 2013). Additionally, genetic variation is an important contributor to smoking for cardiovascular disease. An important gene in our body called NPC1 is responsible for regulating the NPC1 protein for transporting cholesterol and lipids. A malfunction of the protein can cause a buildup of cholesterol and other lipids in the body (Ma, 2010), which could cause excess cholesterol, block blood vessels, and lead to a heart attack. Evidence has shown that smoking can cause variation in NPC1 and consequently lead to dysfunction in cholesterol and lipid regulation, thereby leading to coronary heart disease (Ma, 2010).