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smoking cessation reduces CVD risk.7 However, estimates of the time course of CVD risk reduction among former smokers following cessation have been inconsistent relative to persistent smokers (2-10 years),8-12 and never smokers (2-20 years).8-12 Some clinical CVD risk calculators do not distinguish risk between never smokers and former smokers.13 The Atherosclerotic CVD (ASCVD) Risk Estimator Plus allows clinicians to identify former smokers but considers their CVD risk identical to never smokers after 5 years.14 Uncertainty about the time course of CVD risk reduction following smoking cessation could underestimate CVD risk among former smokers, a group increasing as US smoking prevalence declines.15 Cardiovascular disease risk estimates among former smokers could be improved by frequent, long-term smoking exposure assessment (including status, intensity, abstinence periods, and relapse), objective and time-updated assessment of other CVD risk factors, and continuous CVD incidence surveillance

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