title: Tar yield of cigarettes and risk of acute myocardial infarction. GISSI-EFRIM Investigators.
abstract: OBJECTIVE
  To analyse the relation between tar and nicotine yield of cigarettes smoked in the recent past and the risk of myocardial infarction.
  
  
  METHODS
  Multicentre case-control study conducted between September 1988 and June 1989.
  
  
  METHODS
  Over 80 coronary care units in various Italian regions.
  
  
  METHODS
  916 patients with acute myocardial infarction without history of ischaemic heart disease and 1106 controls admitted to hospital for acute conditions not related to known or suspected risk factors for ischaemic heart disease.
  
  
  METHODS
  Relative risk of myocardial infarction according to type of cigarette smoked adjusted for identified potential confounding factors. Brands of cigarettes classified according to yield of tar and nicotine.
  
  
  RESULTS
  Patients with acute myocardial infarction were more often smokers and among smokers they tended to smoke more cigarettes. Compared with non-smokers their estimated relative risks were 3.8, 4.3, 3.2, and 3.7 in the four categories of tar yield (< 10, 10-15, > 15-20, and > 20 mg, respectively). No trend in risk across yields was evident when analysis was restricted to smokers and allowance was made for number of cigarettes. Compared with risks in subjects in the lowest category of tar yield the relative risks were 1.2, 0.8, and 1.0 for the subsequent yields. Compared with risks in non-smokers the relative risks ranged from 9.3 to 12.6 below the age of 50 but no trend was observed with increasing yield.
  
  
  CONCLUSIONS
  Changing to cigarettes with a lower tar yield is not an effective means of reducing tobacco related morbidity from myocardial infarction.
authors.affiliation: Mario Negri Institute of Pharmacological Research, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Negri
authors.forename: M G
authors.initials: MG
authors.lastname: Franzosi
authors.forename: C
authors.initials: C
authors.lastname: La Vecchia
authors.forename: L
authors.initials: L
authors.lastname: Santoro
authors.forename: A
authors.initials: A
authors.lastname: Nobili
authors.forename: G
authors.initials: G
authors.lastname: Tognoni
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology*; D009538:Nicotine / Q000032:analysis*; D010947:Plants, Toxic; D012306:Risk; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D013638:Tars / Q000032:analysis*; D014026:Nicotiana / Q000737:chemistry*
chemical_list: D013638:Tars; D009538:Nicotine