Relationships between early cardiovascular risk at mean follow-up 1. 8 years and cigarette smoking status were investigated through analysis of data from participating clinics entered from 1981-1994 in the UK-Lipid Clinics Programme computerised database. Lipid profiles and new cardiovascular events were recorded for 3601 male, 4883 female human non-smokers mean age 44.7 and 53.1 years, 3077 male, 2275 female current smokers age 46.3 and 50.3 years and 7210 male, 4559 female age 49.2 and 53.3 years ever-smokers. Levels of triglycerides and total cholesterol increased across the gradient never/ex/current smoker, with a reverse gradient for HDL-cholesterol. Never-smokers were slightly lighter than other groups and males were younger, differences insufficient to explain the lipid variation. Minor differences in blood pressure between groups did not show this gradient and the development of new hypertension was not consistently related to smoking habits. In contrast the expression of newly-recorded cardiovascular disease was greater and in some categories doubled for current or ex-smokers in contrast with never-smokers. This survey emphasises first, the continuing inadequacy of stop-smoking support even at specialist clinics, second, that patients who give up smoking are to be congratulated and benefit in the long-term but third, that the change in status can be recent and classification as ex-smoker can conceal high short-term risk, for which lipid profiles may also be significant and justify priority attention in management.