Key result
Smokeless tobacco use is associated with adverse cardiovascular effects that are less than those caused by smoking but more than those found in nonusers, despite conflicting mortality evidence.
Why the study?
Does smokeless tobacco use increase cardiovascular risk and mortality compared to non-use or smoking?
Does smokeless tobacco use increase cardiovascular risk and mortality compared to non-use or smoking?
Smokeless tobacco use carries an intermediate cardiovascular risk between smoking and non-use, warranting counseling for cessation.
Acute CV effects similar to smoking warrant clinical caution; conflicting prospective data leaves long-term mortality risk open.
This article discusses the evolution of smokeless tobacco in the United States and interprets the available data on cardiovascular risk factors and cardiovascular mortality associated with its use. There has been a resurgence of smokeless tobacco use since 1970. Smokeless tobacco consistently produces levels of nicotine higher than those seen with smoking and causes similar sympathetic neural stimulation and acute cardiovascular effects. However, there is conflicting evidence from prospective and case-control studies about cardiovascular mortality or myocardial infarction caused by smokeless tobacco use. Smokeless tobacco use is also associated with oral cancers and high-risk behavior in adolescents. Although the evidence is not conclusive, the adverse cardiovascular effects of smokeless tobacco use are less than those caused by smoking but are more than those found in nonusers. It is advisable to counsel all current users of smokeless tobacco to quit. Behavioral counseling, sustained-release bupropion hydrochloride therapy, and nicotine replacement therapy may be safe therapeutic modalities for treatment of smokeless tobacco use.
No takes yet. Share an insight, caveat, or question.
Gupta et al. (2004) conducted a review in Cardiovascular risk associated with smokeless tobacco use. Smokeless tobacco vs. Smoking and nonusers was evaluated on Cardiovascular mortality or myocardial infarction. Smokeless tobacco use is associated with adverse cardiovascular effects that are less than those caused by smoking but more than those found in nonusers, despite conflicting mortality evidence.
Synapse has enriched 3 closely related papers on similar clinical questions. Consider them for comparative context: