Evidence map›Paper›PMID 34999825›Full record

ArticleNicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco2022

Associations of Smokeless Tobacco Use With Cardiovascular Disease Risk: Insights From the Population Assessment of Tobacco and Health Study.

Mary Rezk-Hanna, Umme Shefa Warda, Andrew C Stokes, Jessica Fetterman, Jian Li, Paul M Macey, Muhammad Darawad, Yeonsu Song, Ziyad Ben Taleb, Mary-Lynn Brecht and 1 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.7field-weighted citation impact, top 30% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 12 citations in OpenAlex.

  1. Review
  2. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Mary Rezk-HannaSchool of Nursing, University of California, Los Angeles, Los Angeles, CA, USA.ORCID 0000-0001-9926-5276
Umme Shefa WardaSchool of Nursing, University of California, Los Angeles, Los Angeles, CA, USA.
Andrew C StokesDepartment of Global Health, Boston University School of Public Health, Boston, MA, USA.
Jessica FettermanEvans Department of Medicine and Whitaker Cardiovascular Institute, Boston University School of Medicine, Boston, MA, USA.
Jian LiSchool of Nursing, University of California, Los Angeles, Los Angeles, CA, USA.
Paul M MaceySchool of Nursing, University of California, Los Angeles, Los Angeles, CA, USA.ORCID 0000-0003-4093-7458
Muhammad DarawadSchool of Nursing, University of Jordan, Amman, Jordan.
Yeonsu SongSchool of Nursing, University of California, Los Angeles, Los Angeles, CA, USA.ORCID 0000-0002-2244-2323
Ziyad Ben TalebDepartment of Kinesiology, College of Nursing and Health Innovation, University of Texas at Arlington, Arlington, TX, USA.
Mary-Lynn BrechtSchool of Nursing, University of California, Los Angeles, Los Angeles, CA, USA.
Neal L BenowitzDivision of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, CA, USA.ORCID 0000-0003-2041-8124
University of California, Los Angeles · USBoston University · USThe University of Texas at Arlington · USUniversity of California, San Francisco · USUniversity of Jordan · JO

Funding

PROJECT 5: IMPACT OF CHANGING TOBACCO PRODUCT USE ON HEALTHCARE COSTS FOR GENERAL AND VULNERABLE POPULATIONSU54HL147127 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SPRINGER, MATTHEW LAWRENCE · 2018 to 2022
$20.4M
A Dyadic Telehealth Program to Support Alzheimer’s Disease Patients and Their Caregivers During COVID-19K23AG055668 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI SONG, YEONSU · 2017 to 2022
$1.1M
Novel Methods for Evaluating the Association of Electronic Cigarette Use with Cardiovascular HealthK01HL154130 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI STOKES, ANDREW · 2020 to 2024
$904k
NHLBI NIH HHS K01 HL154130NHLBI NIH HHS U54 HL147127NIA NIH HHS K23 AG055668
6 · The paper itself

Abstract

introductionCigarette smoking is strongly associated with the development of cardiovascular disease (CVD). However, evidence is limited as to whether smokeless tobacco (ST) use is associated with CVD. AIMS AND

methodsUsing data from 4347 adults in the Population Assessment of Tobacco and Health Study (2013-2014), we compared geometric mean concentrations of CVD-related harm biomarkers and biomarkers of exposure among exclusive ST users and exclusive cigarette smokers-in relation to recent nicotine exposure-and never tobacco users, adjusting for age, sex, race/ethnicity, income, body mass index, and CVD. Biomarker levels among exclusive ST users who were former established cigarette smokers were compared with exclusive cigarette smokers.

resultsCompared with cigarette smokers, ST users had significantly higher concentrations of total nicotine equivalents (TNE) but lower concentrations of inflammatory (high-sensitivity C-reactive protein, interleukin-6, intercellular adhesion molecule, fibrinogen) and oxidative stress (8-isoprostane) biomarkers (all p < .05). Biomarker levels among ST users were similar to never smokers. ST users who were former cigarette smokers had lower levels of inflammatory and oxidative stress biomarkers and biomarkers of exposure (cadmium, lead, 1-hydroxypyrene, acrylonitrile, and acrolein), compared with cigarettes smokers (p < .05), despite having higher TNE levels (p < .05). Among cigarette smokers, but not among ST users, inflammatory biomarkers and TNE were highly correlated.

conclusionsST use is not associated with increases in biomarkers of CVD-related harm and exposure, compared with never smokers, despite exposure to nicotine at levels higher than those observed among cigarette smokers. These findings support the concept that increases in CVD risk among cigarette smokers is caused primarily by constituents of tobacco smoke other than nicotine. IMPLICATIONS: Despite having higher levels of nicotine and compared with exclusive cigarette smokers, exclusive ST users (including those who were former cigarette smokers) had significantly lower concentrations of inflammatory and oxidative stress biomarkers, comparable to levels observed among never tobacco users. These findings suggest that increases in CVD risk among cigarette smokers is caused primarily by tobacco constituents other than nicotine and that switching to ST is likely associated with lower CVD risk.

Indexed as

Cardiovascular DiseasesElectronic Nicotine Delivery SystemsTobacco ProductsTobacco, SmokelessAdultBiomarkersHumansNicotineBiomarkersNicotine

Identifiers

PMID34999825
PMCPMC9199939
OpenAlexW4205743377

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.