Evidence map›Paper›PMID 39866105›Full record

ArticleCirculation2025

Differential Associations of Cigar, Pipe, and Smokeless Tobacco Use Versus Combustible Cigarette Use With Subclinical Markers of Inflammation, Thrombosis, and Atherosclerosis: The Cross-Cohort Collaboration-Tobacco Working Group.

Zhiqi Yao, Erfan Tasdighi, Zeina A Dardari, Kunal K Jha, Ngozi Osuji, Tanuja Rajan, Ellen Boakye, Carlos J Rodriguez, Kunihiro Matsushita, Eleanor M Simonsick and 13 more

Erratum issuedAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Circulation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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

6 citing papers in PubMed.

  1. Review
  2. Observational
  3. Review
  4. Review
  5. Review
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

23 authors.

Zhiqi YaoJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.Y., E.T., Z.A.D., K.K.J., N.O., T.R., E.B., M.J.B.).ORCID 0009-0007-7803-4357
Erfan TasdighiJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.Y., E.T., Z.A.D., K.K.J., N.O., T.R., E.B., M.J.B.).
Zeina A DardariJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.Y., E.T., Z.A.D., K.K.J., N.O., T.R., E.B., M.J.B.).
Kunal K JhaJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.Y., E.T., Z.A.D., K.K.J., N.O., T.R., E.B., M.J.B.).ORCID 0000-0002-3166-9335
Ngozi OsujiJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.Y., E.T., Z.A.D., K.K.J., N.O., T.R., E.B., M.J.B.).
Tanuja RajanJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.Y., E.T., Z.A.D., K.K.J., N.O., T.R., E.B., M.J.B.).ORCID 0000-0003-3419-3560
Ellen BoakyeJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.Y., E.T., Z.A.D., K.K.J., N.O., T.R., E.B., M.J.B.).
Carlos J RodriguezThe American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (E.B., C.J.R., M.E.H., E.J.B., A.B., A.P.D., M.J.B.).ORCID 0000-0003-0860-9008
Kunihiro MatsushitaDepartment of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (K.M., L.J.A.).ORCID 0000-0002-7179-718X
Eleanor M SimonsickIntramural Research Program, National Institute on Aging, Baltimore, MD (E.M.S.).ORCID 0000-0002-5460-3494
Joao A C LimaDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD (J.A.C.L.).ORCID 0000-0001-8756-6995
Rachel WidomeDivision of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis (R.W.).ORCID 0000-0001-6476-3478
Debbie L CohenRenal, Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia (D.L.C.).ORCID 0000-0002-1325-315X
Lawrence J AppelDepartment of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (K.M., L.J.A.).ORCID 0000-0002-0673-6823
Amit KheraDivision of Cardiology, University of Texas Southwestern, Dallas (A.K.).ORCID 0000-0001-7255-6874
Michael E HallThe American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (E.B., C.J.R., M.E.H., E.J.B., A.B., A.P.D., M.J.B.).ORCID 0000-0002-5733-1025
Suzanne JuddDepartment of Biostatistics, University of Alabama at Birmingham School of Public Health (S.J.).ORCID 0000-0001-7594-6587
Shelley A ColePopulation Health Program, Texas Biomedical Research Institute, San Antonio (S.A.C.).ORCID 0000-0002-2651-0127
Ramachandran S VasanSchool of Public Health, University of Texas,San Antonio (R.S.V.).ORCID 0000-0001-7357-5970
Emelia J BenjaminThe American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (E.B., C.J.R., M.E.H., E.J.B., A.B., A.P.D., M.J.B.).ORCID 0000-0003-4076-2336
Aruni BhatnagarThe American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (E.B., C.J.R., M.E.H., E.J.B., A.B., A.P.D., M.J.B.).ORCID 0000-0001-6818-0384
Andrew P DeFilippisThe American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (E.B., C.J.R., M.E.H., E.J.B., A.B., A.P.D., M.J.B.).ORCID 0000-0002-5135-9748
Michael J BlahaJohns Hopkins Ciccarone Center for Prevention of Cardiovascular Disease, Baltimore, MD (Z.Y., E.T., Z.A.D., K.K.J., N.O., T.R., E.B., M.J.B.).ORCID 0000-0001-5138-9683

Funding

The Southwest National Primate Research Center Supplement- Infrastructure improvements of ABSL2 holding areasP51OD011133 · OD · TEXAS BIOMEDICAL RESEARCH INSTITUTE · PI Larry S. Schlesinger · 2012 to 2026
$129.7M
UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2M
VCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0M
Institute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1M
Scientific and Data Coordinating Center(SDCC) for the P*U01DK060990 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI FELDMAN, HAROLD I · 2001 to 2017
$50.1M
Clinical and Translational Science Collaborative of ClevelandUL1TR000439 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$50.0M
Michigan Institute for Clinical and Health Research (MCHR)UL1TR000433 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MASHOUR, GEORGE ALEXANDER · 2012 to 2016
$49.9M
Institutional Clinical and Translational Science AwardUL1TR000003 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2012 to 2015
$38.9M
Wake Forest Clinical and Translational Science AwardUL1TR001420 · NCATS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ARD, JAMY D, FOLEY, KRISTIE L · 2015 to 2023
$32.3M
FRAMINGHAM HEART STUDY - YEAR 5 EXAM75N92019D00031 · NHLBI · BOSTON UNIVERSITY MEDICAL CAMPUS · PI RAMACHANDRAN, VASAN · 2019 to 2024
$29.8M
Clinical and Translational Science AwardUL1TR000040 · NCATS · COLUMBIA UNIVERSITY HEALTH SCIENCES · PI GINSBERG, HENRY N · 2012 to 2015
$26.2M
Tulane COBRE in Cardiometabolic Diseases Clinical Research CoreP20GM109036 · NIGMS · TULANE UNIVERSITY OF LOUISIANA · PI Katherine Teresa Mills · 2016 to 2026
$25.3M
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6 · The paper itself

Abstract

backgroundUnderstanding the associations of tobacco product use with subclinical markers is essential in evaluating health effects to inform regulatory policy. This is particularly relevant for noncigarette products (eg, cigars, pipes, and smokeless tobacco), which have been understudied because of their low prevalence in individual cohorts.

methodsThis cross-sectional study included 98 450 participants from the Cross-Cohort Collaboration-Tobacco data set. Associations between the use of tobacco products and subclinical markers (high-sensitivity C-reactive protein, interleukin-6, fibrinogen, D-dimer, coronary artery calcium, carotid intima-media thickness, carotid plaque, and ankle-brachial index) were evaluated. The analyses used multivariable linear and logistic regression models to examine current use status for each product, with additional analyses of "sole" and "exclusive" noncigarette use (versus never use of either cigarettes or specific noncigarette tobacco). Sole use was defined as the current use of a given noncigarette tobacco without concurrent combustible cigarette use, whereas exclusive use was defined as current noncigarette tobacco use without any history of combustible cigarette use.

resultsA total of 20.0%, 3.0%, 0.8%, and 1.5% of participants were current cigarette, cigar, pipe, or smokeless tobacco users, respectively. Current cigarette use was linked to higher levels of all markers compared with never cigarette use. Compared with respective reference groups, current, sole, and exclusive cigar use was associated with 10% (95% CI, 1-20), 19% (95% CI, 12-26), and 11% (95% CI, 2-21) higher high-sensitivity C-reactive protein levels on the geometric mean scale. Similar associations were noted for pipe and smokeless tobacco use. For interleukin-6, we observed that sole cigar use was associated with a 15% (95% CI, 6-24) higher level, whereas current, sole, and exclusive pipe use were associated with 22% to 32% (all

conclusionsUse of noncigarette tobacco products is linked to subclinical markers related to cardiovascular harm. Inflammatory markers, such as high-sensitivity C-reactive protein and interleukin-6, have the potential for assessing early cardiovascular harm from using these products and aiding regulatory authorities in evaluating their associated risks.

Indexed as

AtherosclerosisInflammationThrombosisTobacco ProductsTobacco, SmokelessAdultAgedBiomarkersCarotid Intima-Media ThicknessCohort StudiesC-Reactive ProteinCross-Sectional StudiesFemaleHumansInterleukin-6MaleBiomarkersC-Reactive ProteinInterleukin-6inflammationsmokingtobacco products

Identifiers

PMID39866105
PMCPMC11975489

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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.