ArticleAmerican journal of health promotion : AJHP2023
Association of Cardiovascular Disease Risk Factors with Exclusive Smokeless Tobacco Use among US Males: Cross-Sectional Analysis of NHANES Data 2003-2018.
Article in American journal of health promotion : AJHP, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 10 citations in OpenAlex.
- Nicotine-containing products and the cardiovascular system: mechanisms and global health implications.Nature reviews. Cardiology · 2026Review
- Nicotine-Mediated Redox and Nitrosative Stress in Cardiorenal Health.Hypertension (Dallas, Tex. : 1979) · 2026Review
- Tobacco use and associated factors among adults in Ghana: evidence from the 2022 Ghana Demographic and Health Survey.BMJ open · 2026Article
- Nicotine and the cardiovascular system: unmasking a global public health threat.European heart journal · 2025Article
- Lifetime Cannabis, Non-Cigarette Tobacco, and Illicit Drug Use and Cardiovascular Disease Among Young and Middle-Aged U.S. Adults.American journal of lifestyle medicine · 2025Article
- Estimating lung cancer risk from e-cigarettes and heated tobacco products: applications of a tool based on biomarkers of exposure and of potential harm.Harm reduction journal · 2025Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
purposeTo evaluate cardiovascular disease (CVD) risk factors among smokeless tobacco (ST) users. Exclusive ST users were compared to exclusive cigarette smokers and non-tobacco users.
designCross-sectional study. SAMPLE: Data were used from 16,336 adult males who participated in one of the National Health and Nutrition Examination Surveys (NHANES) from 2003 to 2018. MEASURES: Biochemically verified tobacco use, CVD risk factors (hypertension, cholesterol levels, BMI categories), physical activity, cotinine concentration, and sociodemographic variables. ANALYSIS: Weighted analysis of the aggregate data was performed. ST users were compared with cigarette smokers and nontobacco users for their association with CVD risk factors. Associations were examined using univariate and multiple logistic regression with odds ratios (OR) and 95% confidence intervals (CI) reported.
resultsPrevalence of exclusive ST use was 4.4% whereas, exclusive smoking was 22.2%. Among ST users, 36.2% were hypertensive, 24.5% had high cholesterol levels, and most of them were overweight (31.1%) or obese (52.6%). ST users were more likely to have hypertension compared to smokers (aOR = 1.48, 95%CI: 1.12, 1.95) and nontobacco users (aOR = 1.41, 95%CI: 1.09, 1.83) adjusted for other covariates. ST users were twice more likely to be obese than nontobacco users (aOR = 2.18, 95%CI: 1.52, 3.11). ST users had significantly higher cotinine concentration than smokers.
conclusionStudy findings indicate substantial association of ST use among males with hypertension and obesity which are independent risk factors of CVD.
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