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It was suggested, As the blood flow decreases due to narrowed blood vessels, the working muscles dont get enough oxygen-rich blood when it is needed the most during intense workouts, which means you can get into the anaerobic state (a state where your body starts producing lactic acid, the reason behind the burning sensation felt in the muscles) very easily, which leads to very low endurance. Moreover, hemoglobin also binds the carbon monoxide inhaled from cigarettes which then reduces the flexibility of oxygen transport in different parts of the body

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Ensure the parking brake is firmly applied

A meter to measure carbon monoxide in breath can be used to guide treatment