The Risk of Hypertension and Other Chronic Diseases: Comparing Smokeless Tobacco with Smoking

Anand, Ankit; Sk, Illias Kanchan

doi:10.3389/fpubh.2017.00255

Cited by 15 publications

(10 citation statements)

References 28 publications

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“…An Indian cross-sectional study reported no increased diabetes or hypertension in exclusive SLT-product users [ 18 ], although former smoking was not accounted for. An Indian cross-sectional study of 36 individuals with mental and behavioral disorders reported no association with CHD compared with exclusive smokers [ 19 ]; another study with 30 exclusive SLT-product users reported strong associations with dyslipidaemia (OR = 6.37; 95% CI 1.4–27.3) and hypertension (OR = 6.97; 95% CI 1.7–28.0) compared with non-tobacco users [ 20 ].…”

Section: Resultsmentioning

confidence: 99%

The health impact of smokeless tobacco products: a systematic review

Hajat

Stein²,

Ramström

et al. 2021

Harm Reduct J

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Introduction The objective was to systematically review studies on health outcomes from smokeless tobacco (SLT) products. Methods We analysed published literature on the health outcomes from SLT use between 01/01/2015 to 01/02/2020, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) protocol using PubMed, Embase, Scopus, and Google Scholar. Results Of 53 studies included, six were global, 32 from Asia, Middle East and Africa (AMEA), nine from USA and six from Europe. ‘Poor’-rated studies predominated (23;43%), in particular, for global (4;66%) and AMEA (16;50%). Health outcomes differed between SLT-products and regions; those in AMEA were associated with higher mortality (overall, cancer, Coronary heart disease (CHD), respiratory but not cardiovascular disease (CVD)), and morbidity (CVD, oral and head and neck cancers), with odds ratios up to 38.7. European studies showed no excess mortality (overall, CVD, from cancers) or morbidity (ischemic heart disease (IHD), stroke, oral, head and neck, pancreatic or colon cancers) from several meta-analyses; single studies reported elevated risk of rectal cancer and respiratory disorders. Pooled study data showed protection against developing Parkinson’s disease. US studies showed mixed results for mortality (raised overall, CHD, cancer and smoking-related cancer mortality; no excess risk of respiratory or CVD mortality). Morbidity outcomes were also mixed, with some evidence of increased IHD, stroke and cancer risk (oral, head and neck). No studies reported on switching from cigarettes to SLT-products. Conclusion Our review demonstrates stark differences between different SLT-products in different regions, ranging from zero harm from European snus to greatly increased health risks in AMEA. The literature on the safety profile for SLT-products for harm reduction is incomplete and potentially misinforming policy and regulation.

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Section: Resultsmentioning

confidence: 99%

The health impact of smokeless tobacco products: a systematic review

Hajat

Stein²,

Ramström

et al. 2021

Harm Reduct J

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“…In addition, in keeping with previous literature, we found tobacco users to have a higher probability of discordant MM which included lung disease, asthma, arthritis and angina, compared with non-tobacco users. [36][37][38] For example, in a study by Fonda et al aimed at examining the clustering of post-traumatic stress disorder, depressive disorders and clinically significant pain among 433 deployed veterans in Boston (USA) aged 18-65 years, tobacco smokers had 3.5 increased likelihood for MM. 39 The findings from this study should be viewed in light of some limitations.…”

Section: Discussionmentioning

confidence: 99%

Identifying co-occurrence and clustering of chronic diseases using latent class analysis: cross-sectional findings from SAGE South Africa Wave 2

et al. 2021

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ObjectivesTo classify South African adults with chronic health conditions for multimorbidity (MM) risk, and to determine sociodemographic, anthropometric and behavioural factors associated with identified patterns of MM, using data from the WHO’s Study on global AGEing and adult health South Africa Wave 2.DesignNationally representative (for ≥50-year-old adults) cross-sectional study.SettingAdults in South Africa between 2014 and 2015.Participants1967 individuals (men: 623 and women: 1344) aged ≥45 years for whom data on all seven health conditions and socioeconomic, demographic, behavioural, and anthropological information were available.MeasuresMM latent classes.ResultsThe prevalence of MM (coexistence of two or more non-communicable diseases (NCDs)) was 21%. The latent class analysis identified three groups namely: minimal MM risk (83%), concordant (hypertension and diabetes) MM (11%) and discordant (angina, asthma, chronic lung disease, arthritis and depression) MM (6%). Using the minimal MM risk group as the reference, female (relative risk ratio (RRR)=4.57; 95% CI (1.64 to 12.75); p =0.004) and older (RRR=1.08; 95% CI (1.04 to 1.12); p<0.001) participants were more likely to belong to the concordant MM group, while tobacco users (RRR=8.41; 95% CI (1.93 to 36.69); p=0.005) and older (RRR=1.09; 95% CI (1.03 to 1.15); p=0.002) participants had a high likelihood of belonging to the discordant MM group.ConclusionNCDs with similar pathophysiological risk profiles tend to cluster together in older people. Risk factors for MM in South African adults include sex, age and tobacco use.

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“…Another important finding of our study is that the PMT users have elevated BP (diastolic BP [DBP] and systolic BP [SBP]) as compared with nonusers which is consistent with various studies carried out at different places. 9 , 24 , 25 , 26 , 27 It is speculated that the role of sustained vasoconstriction due to prolonged nicotine absorption, high salt concentration, and licorice occurring in ST can be a cause of HTN in PMT users. 15 , 24 A 15-year follow-up study conducted in Sweden found the development of HTN in ST users and were at relative risk of HTN of 1.43; in another population-based study, the risk of having DBP was 1.8 times and SBP was 1.7 times in ST users.…”

Section: Discussionmentioning

confidence: 99%

Correlation of urinary cotinine with cardiovascular risk factors in pan masala tobacco users

Shrestha¹,

Mishra

Dhakal³

et al. 2019

Indian Heart Journal

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Background Tobacco consumption is considered as one of the major risk factors for cardiovascular (CV) morbidity. However, the effect of paan masala tobacco (PMT) (a type of smokeless tobacco) consumption has not been well studied in our context. Our study is aimed to find an association of CV risk factors between PMT users and nonusers and to correlate those parameters with urinary cotinine level, a degradation product of nicotine occurring in tobacco. Methods This comparative cross-sectional study was carried out among 200 participants. The effect of PMT use on CV risk factors such as blood pressure (BP), lipid profile, and body mass index was measured against urine cotinine level. Statistical tests used were χ 2 test for categorical variable, independent t -test, Mann–Whitney U test, and Spearman's correlation applied for numerical variable, and multivariate regression analysis was performed as required. The level of significance was set at p < 0.05. Result Mean BP, total cholesterol, triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and median cotinine level were found to be significantly higher in PMT users than in controls ( p < 0.001). Urinary cotinine level was positively correlated with mean BP, TC, TG, and LDL-C in PMT users ( p < 0.001). Similarly, the odds of having hypercholesterolemia and increased diastolic BP was also significantly higher in PMT users ( p < 0.001). Conclusion PMT use has an adverse effect on CV risk parameters and there is a rational of cotinine measurement for screening CV risk among PMT users.

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The Risk of Hypertension and Other Chronic Diseases: Comparing Smokeless Tobacco with Smoking

Cited by 15 publications

References 28 publications

The health impact of smokeless tobacco products: a systematic review

The health impact of smokeless tobacco products: a systematic review

Identifying co-occurrence and clustering of chronic diseases using latent class analysis: cross-sectional findings from SAGE South Africa Wave 2

Correlation of urinary cotinine with cardiovascular risk factors in pan masala tobacco users

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