Patients using smokeless tobacco and smokers had comparable CAD risk profiles, with no significant difference in disease severity or vessel involvement.
Does smokeless tobacco use result in different clinical and angiographic patterns of coronary artery disease compared to tobacco smoking in patients with CAD?
Smokeless tobacco users and smokers with CAD have comparable angiographic disease severity, suggesting smokeless tobacco carries a similar cardiovascular risk profile to smoking.
A BSTRACT Aim: To determine whether patients who use smokeless tobacco have different clinical and angiographic profiles of coronary artery disease (CAD) compared with smokers. Material and Methods: This cross-sectional, prospective study was conducted on 40 patients with CAD using smokeless tobacco products and 40 patients with CAD who were smokers. Demographic information, history, and present smoking status of tobacco were also obtained. As a means of determining the severity and extent of CAD in all patients, coronary angiography was performed as previously described. Blood samples were collected for lipid profile and fasting blood glucose, and other investigations were also given. Results: The angiographic characteristics also revealed no difference in single-, double-, and triple-vessel disease distribution between the two groups. Smokers consumed tobacco in a larger quantity and had a slightly higher proportion of more severe stenosis (>70%) compared to users of smokeless tobacco, but this was statistically insignificant. Conclusion: CAD risk profiles of smokeless tobacco users and smokers are comparable, thus establishing that smokeless tobacco has similar cardiovascular risk to tobacco smoking.
Pawandeep et al. (2026) studied this question. Patients using smokeless tobacco and smokers had comparable CAD risk profiles, with no significant difference in disease severity or vessel involvement.