title: Tobacco and myocardial infarction: is snuff less dangerous than cigarettes?
abstract: 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.
authors: Department of Medicine, Luleå-Boden Hospital, Sweden.
authors: F
authors: F
authors: Huhtasaari
authors: K
authors: K
authors: Asplund
authors: V
authors: V
authors: Lundberg
authors: B
authors: B
authors: Stegmayr
authors: P O
authors: PO
authors: Wester
mesh_terms: 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*