Exposure to tobacco is central to the initiation, maintenance, and progression of thromboangiitis obliterans. Although smoking tobacco is by far the most common risk factor, thromboangiitis obliterans may also develop as a result of chewing tobacco or marijuana use. Nearly two thirds of patients with thromboangiitis obliterans have severe periodontal disease, and chronic anaerobic periodontal infection may represent an additional risk factor for the development of the disease. Polymerase chain reaction analysis demonstrated DNA fragments from anaerobic bacteria in both arterial lesions and oral cavities of patients with thromboangiitis obliterans but not in arterial samples from healthy control subjects.

According to the theory of traditional Chinese medicine, there are some patterns of syndrome that lead to thromboangiitis obliterans.
1. Stagnation of Qi and blood
2. Cold inducing stagnation
3. Accumulation of internal heat
4. Accumulation of toxic heat
5. Deficiency of Qi and blood