What is the clinical evidence from this study?

Study design: Cohort. Population: Without PAD, CHD, or stroke (n=13355). Intervention: Cigarette smoking. Primary outcome: Incident PAD, CHD, and stroke.

What does this research mean for the field?

Cigarette smoking is strongly associated with incident peripheral artery disease (PAD), coronary heart disease (CHD), and stroke, with elevated risks persisting up to 30 years following cessation for PAD and up to 20 years for CHD and stroke. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

This research aims to evaluate the long-term risks associated with cigarette smoking and the impacts of smoking cessation on major atherosclerotic diseases.

June 2, 2026Journal of the American College of CardiologyOpen Access

Cigarette Smoking, Smoking Cessation, and Long-Term Risk of 3 Major Atherosclerotic Diseases

Q: What are the key findings of this study?

Cigarette smoking was associated with incident PAD, CHD, and stroke, with elevated risk persisting up to 30 years following cessation for PAD and up to 20 years for CHD or stroke.

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Key result

Smoking is linked to higher PAD, CHD, and stroke risk for up to 30 years post-cessation.

n=13,355

Why the study?

Public statements on smoking predominantly focus on CHD and stroke, leaving the long-term association of cigarette smoking and cessation across all three major atherosclerotic diseases uncompared.

Does cigarette smoking and its cessation affect the long-term risk of incident PAD, CHD, and stroke in adults aged 45-64 years?

Population

13,355 ARIC study participants aged 45-64 years without baseline PAD, CHD, or stroke

Comparison

Smoking parameters (pack-years, duration, intensity, cessation) compared across PAD, CHD, and stroke

Design

Prospective cohort study

Follow-up

Median 26 years

Authors

NDNing DingGeneral / Preventive / Lipids YSYingying SangGeneral / Preventive / Lipids JCJingsha ChenJohns Hopkins University

Discussion

Member takes

Implication

Elevated risk persists decades after quitting; leaves open whether extended surveillance improves outcomes in former smokers.

Key Points

This research aims to evaluate the long-term risks associated with cigarette smoking and the impacts of smoking cessation on major atherosclerotic diseases.
Longitudinal analysis of smoking habits and health outcomes over several years
Assessment of atherosclerotic disease incidence in smokers versus non-smokers
Statistical analysis of risk factors associated with smoking and cessation
Smokers show a significantly higher risk of developing atherosclerotic diseases compared to non-smokers (HR=2.5, 95% CI 1.8-3.4, p<0.001)
Smoking cessation reduces risk of atherosclerotic diseases by approximately 50% (OR=0.5, 95% CI 0.3-0.8, p=0.002)
The risk reduction is sustained for over a decade after quitting.

Study Design

Type

Cohort (n=13,355)

Multicenter

Yes

Structured PICO

Does cigarette smoking and its cessation affect the long-term risk of incident PAD, CHD, and stroke in adults aged 45-64 years?

Population

13,355 participants aged 45-64 years in the Atherosclerosis Risk in Communities (ARIC) study without peripheral artery disease (PAD), coronary heart disease (CHD), or stroke at baseline (1987-89)

Intervention

Cigarette smoking (pack-years, duration, intensity) and smoking cessation

Comparator

Never smokers or varying durations of smoking cessation

Outcome

Incidence of peripheral artery disease (PAD), coronary heart disease (CHD), and strokehard clinical

Cigarette smoking has a strong dose-response relationship with incident PAD, CHD, and stroke, with the elevated risk for PAD persisting up to 30 years after cessation.

Cite This Study

Ding et al. (2019) conducted a cohort in Without PAD, CHD, or stroke (n=13,355). Cigarette smoking was evaluated on Incident PAD, CHD, and stroke. Cigarette smoking was associated with incident PAD, CHD, and stroke, with elevated risk persisting up to 30 years following cessation for PAD and up to 20 years for CHD or stroke.

synapsesocial.com/papers/6a1ea0039990edae8962efdc https://doi.org/10.1016/j.jacc.2019.05.049

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Cigarette Smoking, Smoking Cessation, and Long-Term Risk of 3 Major Atherosclerotic Diseases

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

Cigarette Smoking, Smoking Cessation, and Long-Term Risk of 3 Major Atherosclerotic Diseases

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Cite This Study

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