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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: a case-control study
Lancet, Volume 368, No. 9536, Year 2006
Notification
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Description
Background: Tobacco use is one of the major avoidable causes of cardiovascular diseases. We aimed to assess the risks associated with tobacco use (both smoking and non-smoking) and second hand tobacco smoke (SHS) worldwide. Methods: We did a standardised case-control study of acute myocardial infarction (AMI) with 27 089 participants in 52 countries (12 461 cases, 14 637 controls). We assessed relation between risk of AMI and current or former smoking, type of tobacco, amount smoked, effect of smokeless tobacco, and exposure to SHS. We controlled for confounders such as differences in lifestyles between smokers and non-smokers. Findings: Current smoking was associated with a greater risk of non-fatal AMI (odds ratio [OR] 2·95, 95% CI 2·77-3·14, p<0·0001) compared with never smoking; risk increased by 5·6% for every additional cigarette smoked. The OR associated with former smoking fell to 1·87 (95% CI 1·55-2·24) within 3 years of quitting. A residual excess risk remained 20 or more years after quitting (1·22, 1·09-1·37). Exclusion of individuals exposed to SHS in the never smoker reference group raised the risk in former smokers by about 10%. Smoking beedies alone (indigenous to South Asia) was associated with increased risk (2·89, 2·11-3·96) similar to that associated with cigarette smoking. Chewing tobacco alone was associated with OR 2·23 (1·41-3·52), and smokers who also chewed tobacco had the highest increase in risk (4·09, 2·98-5·61). SHS was associated with a graded increase in risk related to exposure; OR was 1·24 (1·17-1·32) in individuals who were least exposed (1-7 h per week) and 1·62 (1·45-1·81) in people who were most exposed (>21 h per week). Young male current smokers had the highest population attributable risk (58·3%; 95% CI 55·0-61·6) and older women the lowest (6·2%, 4·1-9·2). Population attributable risk for exposure to SHS for more than 1 h per week in never smokers was 15·4% (12·1-19·3). Conclusion: Tobacco use is one of the most important causes of AMI globally, especially in men. All forms of tobacco use, including different types of smoking and chewing tobacco and inhalation of SHS, should be discouraged to prevent cardiovascular diseases. © 2006 Elsevier Ltd. All rights reserved.
Authors & Co-Authors
Teo, Koonkang
Canada, Hamilton
Mcmaster University
Ôunpuu, Stephanie
Canada, Hamilton
Mcmaster University
Hawken, Steven J.
Canada, Hamilton
Mcmaster University
Pandey, MR
Nepal, Kathmandu
Nepal Health Research Council
Valentín, Vicent
Spain, Valencia
Hospital Universitario Dr. Peset
Hunt, David
Australia, Melbourne
University of Melbourne
Díaz, Rafaël J.
Argentina, Rosario
Instituto Cardiovascular de Rosario
Rashed, Wafa A.
Kuwait, Kuwait City
Kuwait University
Freeman, Rosario V.
United States, Seattle
University of Washington
Jiang, Lixin
China, Beijing
Cardiovascular Institute
Zhang, Xiaofei
China, Beijing
Cardiovascular Institute
Yusuf, Salim N.
Canada, Hamilton
Mcmaster University
Statistics
Citations: 871
Authors: 12
Affiliations: 8
Identifiers
Doi:
10.1016/S0140-6736(06)69249-0
ISSN:
01406736
Research Areas
Noncommunicable Diseases
Substance Abuse
Study Design
Cross Sectional Study
Case-Control Study
Participants Gender
Male
Female