Benefit of Discontinuing Smokeless Tobacco After Myocardial Infarction

Benefit of discontinuing smokeless tobacco after myocardial infarction

A study by Gabriel et al [1] evaluated whether discontinuation of smokeless tobacco has any mortality benefit after a myocardial infarction. They found that the mortality benefit is similar to that obtained with smoking cessation. Hence they strongly recommend cessation of smokeless tobacco use. In that study mortality rate was 9.7 per 1000 person-years in those who quit smokeless tobacco after a myocardial infarction while it was 18.7 per 1000 person-years in those who continued to use it. They concluded that discontinuation of snus use after a myocardial infarction was associated with a nearly halving of mortality risk, which was similar to the benefit associated with smoking cessation. The hazard ratio was 0.57 for discontinuation of snus use after myocardial infarction while it was 0.54 for those who quit smoking after myocardial infarction.

The smokeless tobacco product evaluated in this study was snus. It is a moist smokeless tobacco product, originating from a variant of the dry snuff of early 18th century Sweden. The moist powder is placed in the upper lip for extended periods.

Reference

  1. Gabriel Arefalk, Kristina Hambraeus, Lars Lind, Karl Michaëlsson, Bertil Lindahl, Johan Sundström. Discontinuation of Smokeless Tobacco and Mortality Risk After Myocardial Infarction. Circulation. 2014; 130: 325-332