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
An erratum to this article was published (Circulation, 8 Apr 2025 ↗)
Authors' conclusion
Use of noncigarette tobacco products is linked to subclinical markers related to cardiovascular harm.
Study context
- Population
- Participants of the Cross-Cohort Collaboration-Tobacco data set
- Participants
- 98,450 participants
- Exposure
- Current cigar, pipe or smokeless tobacco use vs never use; current cigarette use vs never cigarette use
- Outcome
- Subclinical markers: hs-CRP, interleukin-6, fibrinogen, D-dimer, CAC, carotid intima-media thickness, carotid plaque, ankle-brachial index
Methodological detailspooled multicohort data
- Pooled multicohort data
Main finding
As reported in the abstract
High-sensitivity C-reactive protein (geometric mean scale)
% higher
10%
95% CI 1–20
Cigar (current) vs Reference
% higher
19%
95% CI 12–26
Cigar (sole) vs Reference
% higher
11%
95% CI 2–21
Cigar (exclusive) vs Reference
Observational data: associations, not effects.
Further findings
Prevalence of current use
| Outcome | % higher (95% CI) |
|---|---|
| Interleukin-6Cigar (sole) vs Reference | 15% (6–24) |
- Interleukin-6 — Current, sole and exclusive pipe use: 22% to 32% higher levels
- all P values <0.05
Fibrinogen
- 2% to 6% higher among sole users of cigars, pipes and smokeless tobacco
- all P values <0.05
Carotid plaque and carotid intima-media thickness
- Noncigarette tobacco use moderately associated
Original publication
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. Circulation. Published 27 January 2025. doi:10.
Summarised from the published abstract; every number is checked against it