title: Smoking, Smoking Cessation, and Measures of Subclinical Atherosclerosis in Multiple Vascular Beds in Japanese Men.
abstract: Smoking is an overwhelming, but preventable, risk factor for cardiovascular diseases (CVD), although smoking prevalence remains high in developed and developing countries in East Asia.
  
  
  
  In a population-based sample of 1019 Japanese men aged 40 to 79 years, without CVD, we examined cross-sectional associations of smoking status, cumulative pack-years, daily consumption, and time since cessation, with subclinical atherosclerosis at 4 anatomically distinct vascular beds, including coronary artery calcification, carotid intima-media thickness (CIMT) and plaque, aortic artery calcification (AoAC), and ankle-brachial index. Current, former, and never smoking were present in 32.3%, 50.0%, and 17.7%, respectively. Compared to never smokers, current smokers had significantly higher risks of subclinical atherosclerosis in all 4 circulations (eg, odds ratios for coronary artery calcification >0, 1.79 [95% CIs, 1.16-2.79]; CIMT >1.0 mm, 1.88 [1.02-3.47]; AoAC >0, 4.29 [2.30-7.97]; and ankle-brachial index <1.1, 1.78 [1.16-2.74]) and former smokers did in carotid and aortic circulations (CIMT >1.0 mm, 1.94 [1.13-3.34]; and AoAC >0, 2.55 [1.45-4.49]). Dose-response relationships of pack-years and daily consumption, particularly with CIMT, carotid plaque, AoAC, and ankle-brachial index, were observed among both current and former smokers, and even a small amount of pack-years or daily consumption among current smokers was associated with coronary artery calcification and AoAC, whereas time since cessation among former smokers was linearly associated with lower burdens of all atherosclerotic indices.
  
  
  
  Cigarette smoking was strongly associated with subclinical atherosclerosis in multiple vascular beds in Japanese men, and these associations attenuated with time since cessation.
authors: Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University, Izumo, Japan Department of Public Health, Shiga University of Medical Science, Otsu, Japan Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan hisataka@med.shimane-u.ac.jp.
authors: Takashi
authors: T
authors: Hisamatsu
authors: Department of Public Health, Shiga University of Medical Science, Otsu, Japan Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan.
authors: Katsuyuki
authors: K
authors: Miura
authors: Department of Public Health, Shiga University of Medical Science, Otsu, Japan Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University, Fukuoka, Japan.
authors: Hisatomi
authors: H
authors: Arima
authors: Department of Public Health, Shiga University of Medical Science, Otsu, Japan Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan.
authors: Aya
authors: A
authors: Kadota
authors: Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors: Sayaka
authors: S
authors: Kadowaki
authors: Department of Public Health, Shiga University of Medical Science, Otsu, Japan Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
authors: Sayuki
authors: S
authors: Torii
authors: Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors: Sentaro
authors: S
authors: Suzuki
authors: Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors: Naoko
authors: N
authors: Miyagawa
authors: Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors: Atsushi
authors: A
authors: Sato
authors: Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors: Masahiro
authors: M
authors: Yamazoe
authors: Department of Public Health, Shiga University of Medical Science, Otsu, Japan.
authors: Akira
authors: A
authors: Fujiyoshi
authors: Department of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo, Japan.
authors: Takayoshi
authors: T
authors: Ohkubo
authors: Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
authors: Takashi
authors: T
authors: Yamamoto
authors: Department of Radiology, Shiga University of Medical Science, Otsu, Japan.
authors: Kiyoshi
authors: K
authors: Murata
authors: Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan.
authors: Robert D
authors: RD
authors: Abbott
authors: Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA.
authors: Akira
authors: A
authors: Sekikawa
authors: Department of Cardiovascular and Respiratory Medicine, Shiga University of Medical Science, Otsu, Japan.
authors: Minoru
authors: M
authors: Horie
authors: Department of Public Health, Shiga University of Medical Science, Otsu, Japan Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan.
authors: Hirotsugu
authors: H
authors: Ueshima
mesh_terms: D000328:Adult; D000368:Aged; D055109:Ankle Brachial Index; D001018:Aortic Diseases / Q000453:epidemiology*; D044466:Asian People; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000453:epidemiology*; D002340:Carotid Artery Diseases / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D003324:Coronary Artery Disease / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D058729:Peripheral Arterial Disease / Q000453:epidemiology*; D058226:Plaque, Atherosclerotic / Q000453:epidemiology*; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D013997:Time Factors; D000073869:Tobacco Smoking; D061205:Vascular Calcification / Q000453:epidemiology*
keywords: atherosclerosis; coronary artery calcification; cumulative pack‐years exposure; prevention; smoking; smoking cessation