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PLoS Medicine Dec 2020Alcohol consumption and smoking, 2 major risk factors for cardiovascular disease (CVD), often occur together. The objective of this study is to use a wide range of CVD... (Observational Study)
Observational Study
BACKGROUND
Alcohol consumption and smoking, 2 major risk factors for cardiovascular disease (CVD), often occur together. The objective of this study is to use a wide range of CVD risk factors and outcomes to evaluate potential total and direct causal roles of alcohol and tobacco use on CVD risk factors and events.
METHODS AND FINDINGS
Using large publicly available genome-wide association studies (GWASs) (results from more than 1.2 million combined study participants) of predominantly European ancestry, we conducted 2-sample single-variable Mendelian randomization (SVMR) and multivariable Mendelian randomization (MVMR) to simultaneously assess the independent impact of alcohol consumption and smoking on a wide range of CVD risk factors and outcomes. Multiple sensitivity analyses, including complementary Mendelian randomization (MR) methods, and secondary alcohol consumption and smoking datasets were used. SVMR showed genetic predisposition for alcohol consumption to be associated with CVD risk factors, including high-density lipoprotein cholesterol (HDL-C) (beta 0.40, 95% confidence interval (CI), 0.04-0.47, P value = 1.72 × 10-28), triglycerides (TRG) (beta -0.23, 95% CI, -0.30, -0.15, P value = 4.69 × 10-10), automated systolic blood pressure (BP) measurement (beta 0.11, 95% CI, 0.03-0.18, P value = 4.72 × 10-3), and automated diastolic BP measurement (beta 0.09, 95% CI, 0.03-0.16, P value = 5.24 × 10-3). Conversely, genetically predicted smoking was associated with increased TRG (beta 0.097, 95% CI, 0.014-0.027, P value = 6.59 × 10-12). Alcohol consumption was also associated with increased myocardial infarction (MI) and coronary heart disease (CHD) risks (MI odds ratio (OR) = 1.24, 95% CI, 1.03-1.50, P value = 0.02; CHD OR = 1.21, 95% CI, 1.01-1.45, P value = 0.04); however, its impact was attenuated in MVMR adjusting for smoking. Conversely, alcohol maintained an association with coronary atherosclerosis (OR 1.02, 95% CI, 1.01-1.03, P value = 5.56 × 10-4). In comparison, after adjusting for alcohol consumption, smoking retained its association with several CVD outcomes including MI (OR = 1.84, 95% CI, 1.43, 2.37, P value = 2.0 × 10-6), CHD (OR = 1.64, 95% CI, 1.28-2.09, P value = 8.07 × 10-5), heart failure (HF) (OR = 1.61, 95% CI, 1.32-1.95, P value = 1.9 × 10-6), and large artery atherosclerosis (OR = 2.4, 95% CI, 1.41-4.07, P value = 0.003). Notably, using the FinnGen cohort data, we were able to replicate the association between smoking and several CVD outcomes including MI (OR = 1.77, 95% CI, 1.10-2.84, P value = 0.02), HF (OR = 1.67, 95% CI, 1.14-2.46, P value = 0.008), and peripheral artery disease (PAD) (OR = 2.35, 95% CI, 1.38-4.01, P value = 0.002). The main limitations of this study include possible bias from unmeasured confounders, inability of summary-level MR to investigate a potentially nonlinear relationship between alcohol consumption and CVD risk, and the generalizability of the UK Biobank (UKB) to other populations.
CONCLUSIONS
Evaluating the widest range of CVD risk factors and outcomes of any alcohol consumption or smoking MR study to date, we failed to find a cardioprotective impact of genetically predicted alcohol consumption on CVD outcomes. However, alcohol was associated with and increased HDL-C, decreased TRG, and increased BP, which may indicate pathways through impact CVD risk, warranting further study. We found smoking to be a risk factor for many CVDs even after adjusting for alcohol. While future studies incorporating alcohol consumption patterns are necessary, our data suggest causal inference between alcohol, smoking, and CVD risk, further supporting that lifestyle modifications might be able to reduce overall CVD risk.
Topics: Alcohol Drinking; Cardiovascular Diseases; Genetic Predisposition to Disease; Genome-Wide Association Study; Heart Disease Risk Factors; Humans; Mendelian Randomization Analysis; Multivariate Analysis; Polymorphism, Single Nucleotide; Risk Assessment; Tobacco Use
PubMed: 33275596
DOI: 10.1371/journal.pmed.1003410 -
MMWR. Morbidity and Mortality Weekly... Mar 2022Although cigarette smoking has declined over the past several decades, a diverse landscape of combustible and noncombustible tobacco products has emerged in the United...
Although cigarette smoking has declined over the past several decades, a diverse landscape of combustible and noncombustible tobacco products has emerged in the United States (1-4). To assess recent national estimates of commercial tobacco product use among U.S. adults aged ≥18 years, CDC analyzed data from the 2020 National Health Interview Survey (NHIS). In 2020, an estimated 47.1 million U.S. adults (19.0%) reported currently using any commercial tobacco product, including cigarettes (12.5%), e-cigarettes (3.7%), cigars (3.5%), smokeless tobacco (2.3%), and pipes* (1.1%). From 2019 to 2020, the prevalence of overall tobacco product use, combustible tobacco product use, cigarettes, e-cigarettes, and use of two or more tobacco products decreased. Among those who reported current tobacco product use, 79.6% reported using combustible products (e.g., cigarettes, cigars, or pipes), and 17.3% reported using two or more tobacco products. The prevalence of any current commercial tobacco product use was higher among the following groups: 1) men; 2) adults aged <65 years; 3) non-Hispanic American Indian or Alaska Native (AI/AN) adults and non-Hispanic adults categorized as of "Other" race; 4) adults in rural (nonmetropolitan) areas; 5) those whose highest level of educational attainment was a general educational development certificate (GED); 6) those with an annual household income <$35,000; 7) lesbian, gay, or bisexual adults; 8) uninsured adults or those with Medicaid; 9) adults living with a disability; and 10) those who regularly had feelings of anxiety or depression. Continued monitoring of tobacco product use and tailored strategies and policies that reduce the effects of inequitable conditions could aid in reducing disparities in tobacco use (1,4).
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Prevalence; Sociodemographic Factors; Tobacco Products; Tobacco Use; United States; Young Adult
PubMed: 35298455
DOI: 10.15585/mmwr.mm7111a1 -
MMWR. Morbidity and Mortality Weekly... May 2023Commercial cigarette smoking among U.S. adults has declined during the preceding 5 decades (1,2); however, tobacco product use remains the leading cause of preventable...
Commercial cigarette smoking among U.S. adults has declined during the preceding 5 decades (1,2); however, tobacco product use remains the leading cause of preventable disease and death in the United States, and some populations continue to be disproportionately affected by tobacco use (1,2). To assess recent national estimates of commercial tobacco use among U.S. persons aged ≥18 years, CDC, the Food and Drug Administration (FDA), and the National Cancer Institute analyzed 2021 National Health Interview Survey (NHIS) data. In 2021, an estimated 46 million U.S. adults (18.7%) reported currently using any tobacco product, including cigarettes (11.5%), e-cigarettes (4.5%), cigars (3.5%), smokeless tobacco (2.1%), and pipes (including hookah)* (0.9%). Among those who used tobacco products, 77.5% reported using combustible products (cigarettes, cigars, or pipes), and 18.1% reported using two or more tobacco products. The prevalence of current use of any tobacco product use was higher among the following groups: men; persons aged <65 years; persons of non-Hispanic other races; non-Hispanic White (White) persons; residents of rural (nonmetropolitan) areas; financially disadvantaged (income-to-poverty ratio = 0-1.99); lesbian, gay, or bisexual (LGB) persons; those uninsured or enrolled in Medicaid; adults whose highest level of education was a general educational development (GED) certificate; who had a disability; and who had serious psychological distress. Continued surveillance of tobacco product use, implementation of evidence-based tobacco control strategies (e.g., hard-hitting media campaigns, smoke-free policies, and tobacco price increases), conducting linguistically and culturally appropriate educational campaigns, and FDA regulation of tobacco products will aid in reducing tobacco-related disease, death, and disparities among U.S. adults (3,4).
Topics: Male; Female; Adult; Humans; United States; Adolescent; Electronic Nicotine Delivery Systems; Socioeconomic Factors; Health Surveys; Tobacco Use Disorder; Tobacco Products; Tobacco, Smokeless; Cigarette Smoking; Tobacco Use
PubMed: 37141154
DOI: 10.15585/mmwr.mm7218a1 -
BioMed Research International 2015
Topics: Health Promotion; Healthcare Disparities; Humans; Socioeconomic Factors; Tobacco Use; Tobacco Use Cessation
PubMed: 26273632
DOI: 10.1155/2015/570173 -
European Journal of Public Health Aug 2023
Topics: Humans; Europe; Tobacco Use; Tobacco Products
PubMed: 37279360
DOI: 10.1093/eurpub/ckad068 -
Asian Pacific Journal of Cancer... Jun 2022The still debatable contribution of tobacco to the economy demands further discussion as tobacco remains controversial commodity due to its adverse health impacts. This...
OBJECTIVE
The still debatable contribution of tobacco to the economy demands further discussion as tobacco remains controversial commodity due to its adverse health impacts. This paper aims to investigate the relationship between tobacco and the economy using macroeconomics indicators such as unemployment, inflation, and GDP growth. As a comparison, we include the tobacco price bands in USA because the sector is one of dominant affecting the economy and the price in some main areas in America is incredibly competitive.
METHODS
This paper use tobacco data and Macroeconomics Indicators from Euromonitor International and World Bank Data. We extend linear regression models by controlling both the serial correlation and endogeneity bias problems. We also observe the properties in the ARMA(2,2) data generating process.
RESULTS
We document that tobacco tends to affect the USA's future economy but not Indonesia. In our robustness check, we conduct a SUR analysis to control the contemporaneous correlations among Asian markets. We further document that tobacco variables tend not to affect the economy in the Asian markets.
CONCLUSION
Our results show that the contribution of tobacco commodity to the economy is overstated. Therefore, the comprehensive and massive tobacco control implementations should be undertaken hence is relevant to put into actions.
Topics: Humans; Indonesia; Nicotiana; Tobacco Industry; Tobacco Products; Tobacco Use
PubMed: 35763626
DOI: 10.31557/APJCP.2022.23.6.1873 -
Journal of the American College of... Aug 2018Tobacco use is the leading preventable cause of death worldwide and is a major risk factor for cardiovascular disease (CVD). Both prevention of smoking initiation among... (Review)
Review
Tobacco use is the leading preventable cause of death worldwide and is a major risk factor for cardiovascular disease (CVD). Both prevention of smoking initiation among youth and smoking cessation among established smokers are key for reducing smoking prevalence and the associated negative health consequences. Proven tobacco cessation treatment includes pharmacotherapy and behavioral support, which are most effective when provided together. First-line medications (varenicline, bupropion, and nicotine replacement) are effective and safe for patients with CVD. Clinicians who care for patients with CVD should give as high a priority to treating tobacco use as to managing other CVD risk factors. Broader tobacco control efforts to raise tobacco taxes, adopt smoke-free laws, conduct mass media campaigns, and restrict tobacco marketing enhance clinicians' actions working with individual smokers.
Topics: Health Promotion; Humans; Tobacco Use; Tobacco Use Disorder
PubMed: 30139432
DOI: 10.1016/j.jacc.2018.06.036 -
Adicciones Dec 2023
Topics: Humans; Adolescent; Cannabis; Smoking; Marijuana Smoking; Ethanol; Alcohol Drinking; Tobacco Use
PubMed: 38224185
DOI: 10.20882/adicciones.2035 -
Nicotine & Tobacco Research : Official... Aug 2021
Topics: Female; Humans; Longitudinal Studies; Pregnancy; Pregnancy Complications; Smoking Cessation; Tobacco Use
PubMed: 34049403
DOI: 10.1093/ntr/ntab113 -
The European Respiratory Journal Jan 2021
Topics: Humans; Nicotiana; Tobacco Products; Tobacco Use
PubMed: 33402371
DOI: 10.1183/13993003.03499-2020