Discontinuation of snus use after a myocardial infarction was associated with a reduced mortality risk compared to continuing use (multivariable-adjusted HR 0.57; 95% CI 0.32-1.02).
Cohort (n=2,474)
Yes
Does discontinuation of snus use reduce mortality risk in post-MI patients?
Discontinuation of smokeless tobacco (snus) after a myocardial infarction is associated with a nearly halved mortality risk, comparable to the benefits of smoking cessation.
Hazard Ratio: 0.57 (95% CI 0.32–1.02)
Absolute Event Rate: 9.7% vs 18.7%
BACKGROUND: Given the indications of increased risk for fatal myocardial infarction (MI) in people who use snus, a moist smokeless tobacco product, we hypothesized that discontinuation of snus use after an MI would reduce mortality risk. METHODS AND RESULTS: All patients who were admitted to coronary care units for an MI in Sweden between 2005 and 2009 and were <75 years of age underwent a structured examination 2 months after discharge (the baseline of the present study). We investigated the risk of mortality in post-MI snus quitters (n=675) relative to post-MI continuing snus users (n=1799) using Cox proportional hazards analyses. During follow-up (mean 2.1 years), 83 participants died. The mortality rate was 9.7 (95% confidence interval, 5.7-16.3) per 1000 person-years at risk in post-MI snus quitters and 18.7 (14.8-23.6) per 1000 person-years at risk in post-MI continuing snus users. After adjustment for age and sex, post-MI snus quitters had half the mortality risk of post-MI continuing snus users (hazard ratio, 0.51; 95% confidence interval, 0.29-0.91). In a multivariable-adjusted model, the hazard ratio was 0.57 (95% confidence interval, 0.32-1.02). The corresponding estimate for people who quit smoking after MI versus post-MI continuing smokers was 0.54 (95% confidence interval, 0.42-0.69). CONCLUSIONS: In this study, discontinuation of snus use after an MI was associated with a nearly halved mortality risk, similar to the benefit associated with smoking cessation. These observations suggest that the use of snus after MI should be discouraged.
Arefalk et al. (Tue,) conducted a cohort in Myocardial Infarction (n=2,474). Discontinuation of snus use vs. Continuing snus use was evaluated on Mortality (HR 0.57, 95% CI 0.32-1.02). Discontinuation of snus use after a myocardial infarction was associated with a reduced mortality risk compared to continuing use (multivariable-adjusted HR 0.57; 95% CI 0.32-1.02).