Tobacco and myocardial infarction: is snuff less dangerous than cigarettes?
OBJECTIVE
To estimate the risk of myocardial infarction in snuff users, cigarette smokers, and non-tobacco users in northern Sweden, where using snuff is traditional.


METHODS
Case-control study.


METHODS
Northern Sweden.


METHODS
All 35-64 year old men who had had a first myocardial infarction and a population based sample of 35-64 year old men who had not had an infarction in the same geographical area.


METHODS
Tobacco consumption (regular snuff dipping, regular cigarette smoking, non-tobacco use) and risk of acute myocardial infarction.


RESULTS
59 of 585 (10%) patients who had a first myocardial infarction and 87 of 589 (15%) randomly selected men without myocardial infarction were non-smokers who used snuff daily. The age adjusted odds ratio for myocardial infarction was 0.89 (95% confidence interval 0.62 to 1.29) for exposure to snuff and 1.87 (1.40 to 2.48) for cigarette smoking compared with non-tobacco users, showing an increased risk in smokers but not in snuff dippers. Regular cigarette smokers had a significantly higher risk of myocardial infarction than regular snuff dippers (age adjusted odds ratio 2.09; 1.39 to 3.15). Smoking, but not snuff dipping, predicted myocardial infarction in a multiple logistic regression model that included age and level of education.


CONCLUSIONS
In middle aged men snuff dipping is associated with a lower risk of myocardial infarction than cigarette smoking.
Huhtasaari
F
F
Department of Medicine, Luleå-Boden Hospital, Sweden.
Asplund
K
K
Lundberg
V
V
Stegmayr
B
B
Wester
P O
PO
D000328:Adult; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*; D010947:Plants, Toxic; D011897:Random Allocation; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D013548:Sweden / Q000453:epidemiology; D014030:Tobacco, Smokeless / Q000009:adverse effects*