A systematic review on association between smokeless tobacco & cardiovascular diseases

Abstract

Background & objectives:The association of smokeless tobacco (SLT) with cardiovascular diseases has remained controversial due to conflicting reports from various countries. Earlier meta-analyses have shown significantly higher risk of fatal myocardial infarction and stroke in SLT users. However, the risk of hypertension (HTN) with SLT products has not been reviewed earlier. This systematic review was undertaken to summarize the evidence available from global literature on the association of SLT with cardiovascular outcomes – heart disease, stroke and HTN.Methods:A systematic literature search was performed in PubMed and Google Scholar since their inception till October 2017 using pre-decided search terms and inclusion/exclusion criteria. Data were extracted from studies included independently by two authors and reviewed.Results:The review included 50 studies - 23 on heart disease, 14 on stroke and 14 on HTN. Majority of the studies evaluating heart disease or stroke were conducted in the European Region and most of these did not find a significant association between SLT use and either of these outcomes. On the other hand, 70 per cent of the studies on HTN were reported from South-East Asian Region and about half of the studies found a higher risk of HTN in SLT users.Interpretation & conclusions:Current available evidence is insufficient to conclusively support the association of cardiovascular diseases with SLT use due to variability in results and methodological constraints in most of the studies. Region and product-specific well-designed studies are required to provide this evidence to the policymakers. However, advice on cessation of SLT products should be offered to patients presenting with cardiovascular diseases.

Prevalence of non-cancer chronic morbidity in tobacco users among adults in Kolar district: community-based study

“…Diabetes mellitus is likely to develop among tobacco users. 4,8,10,[14][15][16] the prevalence of diabetes mellitus was lower among the above studies compared to the present study findings. The OR for developing diabetes Mellitus was found to be in the range of 1.3 to 4.9).…”

“…workers (nurses), it was found that female smokers were 25% more likely to develop CVD than male workers. 3,4 Prevalence of diabetes mellitus was high in this study (41.2%). Diabetes mellitus is likely to develop among tobacco users.…”

“…The OR for developing diabetes Mellitus was found to be in the range of 1.3 to 4.9). 3,4,10,15,16 This proves that irrespective of geographical location, food habits, and pattern of tobacco use is high risk for diabetes mellitus. It is interesting to note that the incidence of chronic morbidities comes to the equal of non-tobacco users after a decade if the present tobacco users ceases to use.…”

“…1 The global efforts to reduce the deaths from tobacco is showing slow decline in the consumption of tobacco from strict laws and creating awareness about ill effects of tobacco in the developing countries. [1][2][3][4]6 The morbidities are irreversible and leads to premature deaths even among passive smokers. The prevalence of tobacco use is 20% at global level and 28.6% in India among subjects aged 15 years and above.…”

A heveny szívinfarktus okozta országos epidemiológiai és egészségbiztosítási betegségteher Magyarországon

“…Figyelembe véve, hogy a magyar lakosság egészségi állapota a más európai országokban élőkénél kedvezőtlenebb képet mutat, az egyik legfontosabb teendő a szívés érrendszeri betegségek kialakulásában szerepet játszó kockázati tényezők csökkentése, legfőképpen primer prevenciós eszközökkel [41,48,49]. Az elsődleges megelőzésben fontos szerepe lehet a készülő Nemzeti Népegészségügyi Stratégiának is.…”