Among environmental factors influencing unfolding of acute coronary events among youngsters, tobacco smoking, a habit acquired at early ages, and illicit drug addiction, stand out. At young ages the myocardium is deprived of active collateral circulation to deal with an acute ischemic insult and major coronary events are predisposed to have serious consequences to cardiac mechanics, impacting lifestyle and quality of life. Planning strategies to reduce the impact of these injurious habits among young people should be considered by the organized and conscious society.