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adolescents published in the journal Pediatrics, only 35 percent of light smokers, defined as those who consume 10 or fewer cigarettes a day, considered their habits to be associated with "a lot of harm." How Smoking Hurts Your Heart Smoking is at the top of the list of risk factors for heart disease, says Steve Nissen, M.D., chairman of the department of cardiovascular medicine at the Cleveland Clinic in Cleveland, Ohio