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· Health/Science
· Cardio-vascular
· Stroke
· Smokeless
non-USA, by Country
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· USA
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Jump to full article: British Medical Journal, 2009-08-18
Author: Paolo Boffetta, epidemiologist, Kurt Straif, epidemiologist
Intro: In conclusion, in studies carried out in the United States and Sweden we detected an association between use of smokeless tobacco products and risk of fatal myocardial infarction and fatal stroke, which is not readily explained by chance. Confounding and other sources of bias, however, cannot be completely excluded on the basis of available data, although we found no strong evidence for their effect. If the association is real, its public health and clinical implications might be substantial, despite the fact that the magnitude of the excess risk is small. Future research should aim to clarify the mechanisms of effect of smokeless tobacco products on deaths from cardiovascular disease and to elucidate whether a similar effect is present for non-fatal myocardial infarction and non-fatal stroke.
What is already known on this topic Smokeless tobacco products are widely used in many populations An association with risk of cardiovascular disease is plausible
What this study adds This systematic review and meta-analysis provided evidence for an association between use of smokeless products and risk of fatal myocardial infarction and stroke . . .
William T Godshall,
Executive Director, Smokefree Pennsylvania
Pittsburgh, PA USA 15218
Send response to journal:
Re: Smokeless tobacco is far less hazardous alternative to cigarettes
If the attributable risk estimates for fatal stroke and heart disease found by this study are correct, the overall mortality risk from using smokeless tobacco products would be 4%- 5% of those from cigarette smoking, or 95%-96% lower risk.
As such, this study confirms the findings by Rodu and Godshall http://www.harmreductionjournal.com/content/3/1/37 that cigarette smokers can sharply reduce their mortality risks by switching to smokeless tobacco products.
Unfortunately, the authors of this study failed to acknowledge that smokeless tobacco users face significantly fewer mortality risks for stroke and MI (and overall mortality) than cigarette smokers.
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