Hello my friend I am Dr.Arianisa Thanks for your question on HCM Nicotine, a key part of tobacco, is thought to relax the ring of muscle in the lower esophagus that keeps acid in the stomach, where it belongs. When that ring relaxes, acid can trickle up and cause that burning sensation. Smoking can also cause your mouth to make less spit, which might mean more acid reflux symptoms. When reflux happens, acid gets into the lower part of the esophagus. Cigarettes may also make it harder for your body to make a substance that helps guard you from stomach acid. A smoker’s cough won’t help you, either. Each time you cough you get increased reflux because you’re increasing your abdominal pressure. Chewing tobacco is even worse. Because nicotine is released constantly, it could mean more acid reflux. If your husband is overweight, he may want to shed some pounds, too. A recent study of smokers with severe acid reflux symptoms found that quitting only helped those who weren’t overweight. The act of quitting or trying to quit tends to lead to healthier habits. These include eating a more balanced diet and limiting how much alcohol he drink, both of which could help with heartburn symptoms.It sounds simple, but it can make a difference. Hope this information is helpful to you and your husband. Best regards