Noncigarette Tobacco Products Linked to Cardiovascular Risks: Study

The recent large-scale study included about 103,000 participants and investigated the effects of cigars, pipes, and smokeless tobacco.

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People who use cigars, pipes, and smokeless tobacco face higher risks of heart attack, stroke, and other cardiovascular problems compared with nonusers, with health risks varying by the products used, according to a recent study tracking more than 100,000 Americans.

Cardiovascular Risks of Tobacco

The study, conducted by the Cross-Cohort Collaboration-Tobacco Working Group and published in JAMA Network Open on Jan. 13, evaluated data from more than 103,000 participants across the United States. Researchers tracked tobacco use and health outcomes between 1948 and 2015. The average follow-up time for mortality outcomes was 13.8 years.

Different tobacco products posed different health risks, the researchers found.

Current cigar smokers showed significantly higher rates of stroke, atrial fibrillation, and heart failure compared with nonusers. The risks were even more pronounced among exclusive cigar users (who had never used any other tobacco product), particularly for stroke and cardiovascular disease mortality. Cigar users had a 25 percent higher chance of having a stroke, a 32 percent higher chance of developing atrial fibrillation (irregular heartbeat), and a 29 percent higher chance of heart failure compared with those who have never used cigars. Using only cigars increased the risk of stroke by 34 percent.

Pipe smokers also faced health risks, including an increased likelihood of heart failure and significantly higher rates of heart attack compared with nonusers. Current pipe users were 23 percent more likely to develop heart failure than those who had never used pipes. Using only pipes was associated with a 43 percent higher risk of heart attack compared with not using pipes or cigarettes.

Smokeless Tobacco Products Also Unsafe

The study identified smokeless tobacco use as being especially dangerous, with associations linked to heart attack and death from coronary heart disease.

Using only smokeless tobacco was linked to an increased risk of various heart and cardiovascular diseases, with users having a 41 percent higher chance of dying from heart-related issues and an overall mortality increase of 46 percent.

Researchers emphasized the importance of their findings, highlighting that distinct cardiovascular risks are associated with various noncigarette tobacco products. “This study identified distinctive cardiovascular risks associated with the use of noncigarette tobacco products, underscoring the substantial public health implications,” they wrote.

Cigarette Versus Noncigarette Tobacco Products

The study authors concluded that the need for rigorous, evidence-based regulation of noncigarette tobacco products has become increasingly urgent. These findings should inform health officials and policymakers about the dangers that these products pose, as they have not been as thoroughly studied as combustible cigarette smoking.

The researchers noted that the study should not be used as a comparative risk assessment across all tobacco products but that it could “facilitate broad comparison” between cigarette and noncigarette tobacco products. They also stated that overall, in line with previous research, “these findings indicate more pronounced increases in risk and more consistent associations of combustible cigarettes across all 9 outcomes.”