As a 5x winner in the heart-attack race, my doctors have repeatedly explained to me that the tars & burnt manure & pesticides in cigarettes are for the cancer docs (lung, mouth, stomach, bladder, colon & everything in between). But their own prime hatred is for the nicotine itself, which has a wonderful way of attaching itself to all those tiny things in your bloodstream making them way way stickier, meaning they glue themselves to arterial walls and to each other and to cholesterol molecules and to anything else they can glom onto - and thereby create arterial blockages. Particularly in heart muscle (heart-attack bingo), but also in peripheral limbs (ie, Peripheral Artery Disease), and in the carotids (ah, brain oxygenation issues & strokes).