Key result
Self-reported ex-smoking status was significantly associated with cardiovascular disease (OR 1.62) compared to non-smoking, whereas current smoking was not, with hidden female smoking influencing this association.
Why the study?
Korean studies have shown differing results on the association between current smoking status and CVD risk, and the impact of hidden smokers was unclear.
Does smoking status increase the risk of cardiovascular disease in Korean adults?
Cross-Sectional (n=28,620)
Does smoking status increase the risk of cardiovascular disease in Korean adults?
Odds Ratio: 1.62 (95% CI 1.2–2.19)
Hidden female smoking significantly confounds the association between smoking status and cardiovascular disease in Korean adults, highlighting the importance of cotinine verification in epidemiological studies.
Self-reported smoking status should not yet guide CVD risk assessment; leaves open validation of reporting accuracy in observational data.
BACKGROUND: Smoking is a known risk factor for cardiovascular morbidity and mortality, but several Korean studies have shown differing results on the association of current smoking status and the risk of cardiovascular disease (CVD). The aim of the present study was to investigate the association between smoking status and CVD (myocardial infarction and stroke) using national representative populationbased samples. The aim was also to investigate the effects of hidden smokers on the association between CVD and smoking. METHODS: Data were acquired from 28,620 participants (12,875 men and 15,745 women), age 19 years or older, who participated in the Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2008 to 2016. RESULTS: The multivariable logistic regression analysis showed that ex-smoking status was correlated with CVD when self-reported (odds ratio [OR]: 1.62; 95% confidence interval [CI]: 1.20-2.19) and for survey-cotinine verified-smoking status (OR: 1.57; 95% CI: 1.20-2.19). Interestingly, the present study showed current smoking was not significantly associated with CVD. For the effect of sex on smoking and CVD, self-reported and survey-cotinine-verified ex-smoking status were correlated with CVD in males (OR: 1.45; 95% CI: 1.04-2.04 and OR: 1.43; 95% CI: 1.02-2.02) and in females (OR: 2.74; 95% CI: 1.59-4.71 and OR: 2.92; 95% CI: 1.64-5.18). The ratios of cotinine-verified to self-reported smoking rates were 1.95 for women and 1.08 for men. CONCLUSIONS: In the current study, while ex-smoking status was significantly associated with CVD, current smoking status was not. Female ex-smoking status had a higher adjusted odds ratio for CVD than males compared to non-smoking status. An effect of hidden female smoking was also found on the association between smoking status and CVD in Korean adults.
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Hwang et al. (2020) conducted a cross-sectional in Cardiovascular disease (n=28,620). Ex-smoking status vs. Non-smoking status was evaluated on Cardiovascular disease (myocardial infarction and stroke) (OR 1.62, 95% CI 1.20-2.19). Self-reported ex-smoking status was significantly associated with cardiovascular disease (OR 1.62) compared to non-smoking, whereas current smoking was not, with hidden female smoking influencing this association.
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