The Effect of Conventional Cigarette Smoking on Submaximal and Maximal Heart Rate Responses and Post-exercise Heart Rate Recovery- A Narrative Review

Abstract

Background. Conventional cigarette smoking remains a major modifiable risk factor for cardiovascular and respiratory disease. Exercise testing provides a practical framework for assessing how smoking may influence submaximal heart rate, peak heart rate, and post-exercise heart rate recovery.

Aim. The aim of this narrative review was to summarize current evidence on the effect of conventional cigarette smoking on submaximal, maximal and recovery heart rate responses during physical exercise.

Material and methods. A narrative literature review was conducted using the PubMed and Scopus databases. Publications from January 2016 to April 2026 were considered, including full-text original studies, systematic reviews, and meta-analyses addressing cigarette smoking, exercise response, heart rate, autonomic regulation, physical fitness, or cardiopulmonary function.

Results. The reviewed evidence suggests that smoking is associated with altered cardiac autonomic regulation, reduced cardiorespiratory fitness, impaired pulmonary function, and delayed post-exercise recovery. Differences during moderate submaximal exercise may be subtle, whereas limitations become more apparent at ventilatory or lactate thresholds, during peak exercise, and during recovery.

Conclusions. Conventional cigarette smoking may impair the integrated cardiovascular, respiratory, and metabolic response to physical exercise, even in young and physically active individuals. Smoking status and post-exercise heart rate recovery should be considered in sport, clinical, and rehabilitation settings.