ArticleJournal of clinical epidemiology2017
Smoking intensity (pack/day) is a better measure than pack-years or smoking status for modeling cardiovascular disease outcomes.
Article in Journal of clinical epidemiology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparative disease risks associated with cigarette smoking and use of moist smokeless tobacco and snus: an umbrella review of epidemiological evidence from the United States and Western Europe.BMC public health · 2025Pooled it
- Xanthine oxidase inhibitors are associated with reduced risk of cardiovascular disease.Scientific reports · 2021Trial
- Faster CYP2A6 increases COPD and lung cancer risk by increasing smoking quantity: a mediated mendelian randomization and observational mediation study.Respiratory research · 2026Observational
- Sex-Difference of Associations Between Cigarette Smoking and Myocardial Fibrosis: The Multi-Ethnic Study of Atherosclerosis.Journal of the American Heart Association · 2026Article
- Biomechanical characteristics of upper airway muscles and their association with obstructive sleep apnea risk in industrial workers.Sleep & breathing = Schlaf & Atmung · 2026Article
- Early age at smoking initiation is associated with elevated cardiovascular disease and mortality risk in a nationwide population-based cohort.Scientific reports · 2026Article
- Observational studies of exposure to tobacco and nicotine products: Best practices for maximizing statistical precision and accuracy.iScience · 2025Review
- Risk of all-cause mortality by various cigarette smoking indices: A longitudinal study using the Korea National Health Examination Baseline Cohort in South Korea.Tobacco induced diseases · 2025Article
- Association of periodontitis with cardiometabolic and haemostatic parameters.Clinical oral investigations · 2024Article
- Cigarette Smoking and Risk of Hospitalization With Acute Kidney Injury: The Atherosclerosis Risk in Communities (ARIC) Study.American journal of kidney diseases : the official journal of the National Kidney Foundation · 2024Observational
- Association of Multiple Cardiovascular Risk Factors with Musculoskeletal Function in Acute Coronary Syndrome Ward Inpatients.Healthcare (Basel, Switzerland) · 2023Article
- The Longitudinal Association Between Cigarette Coupon Receipt and Short-term Smoking Cessation Among US Adults.Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco · 2023Article
- Effects of Smoking on Optic Nerve Head Microvasculature Density in Glaucoma.Journal of glaucoma · 2022Article
- Article
- Tobacco Consumption and High-Sensitivity Cardiac Troponin I in the General Population: The HUNT Study.Journal of the American Heart Association · 2022Article
- Burden of current and past smoking across 28 European countries in 2017: A cross-sectional analysis.Tobacco induced diseases · 2022Article
- The effect of short term exposure to outdoor air pollution on fertility.Reproductive biology and endocrinology : RB&E · 2021Article
- Environmental Contaminant Body Burdens and the Relationship with Blood Pressure Measures Among Indigenous Adults.Environmental epidemiology (Philadelphia, Pa.) · 2021Article
- Article
- Impact of secondhand smoke exposure in former smokers on their subsequent risk of coronary heart disease: evidence from the population-based cohort of the Tehran Lipid and Glucose Study.Epidemiology and health · 2020Article
Corrections and comments
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Authors and funding
9 authors.
Funding
Abstract
objectivesSmoking as an epidemiological exposure can be quantified in many ways including duration, intensity, pack-years, recency, and age at initiation. However, it is not clear which of these are most important for cardiovascular disease (CVD) and how they should be modeled. STUDY DESIGN AND
settingUsing the Multi-Ethnic Study of Atherosclerosis, Cox models for time to incident CVD adjusted for age, sex, race/ethnicity, education category, and income category were compared which included various characterizations of smoking history.
resultsDuration, age at starting, time since quitting, and noncigarette forms of smoking were not independently associated with CVD, whereas baseline current intensity was associated with CVD [e.g., hard CVD hazard ratio 1 pack/d of 1.85 95% confidence interval (1.33, 2.57)]. Former smokers, regardless of duration, intensity, or recency, were not at increased risk, suggesting that risk may risk may drop precipitously from the time of quitting. For CVD events, representing smoking exposure as baseline smoking intensity produced better model fit as measured by Akaike information criterion than models using smoking status or pack-years.
conclusionThe association of smoking with incident CVD events was well captured by including a simple term for baseline smoking intensity.
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