Quitting Smokeless Tobacco Cuts Mortality Risk Post-MI
(HealthDay News) — Discontinuation of use of a moist smokeless tobacco product, snus (Swedish form of snuff), after myocardial infarction (MI) is associated with a reduced risk of mortality, according to a study published online June 23 in Circulation.
Gabriel Areflak, MD, from Uppsala University in Sweden, and colleagues examined whether discontinuation of snus after MI would reduce mortality using data from 675 post-MI snus quitters and 1,799 post-MI continuing snus users. Participants (aged <75 years) were admitted to a coronary care unit for an MI from 2005–2009 and were interviewed two months after discharge.
The researchers found that 83 participants died during a mean follow-up of 2.1 years. The mortality rates were 9.7 and 18.7 per 1,000 person-years at risk for post-MI snus quitters and post-MI continuing users, respectively. Post MI-snus quitters had half the mortality risk of continuing users after adjustment for age and sex (hazard ratio, 0.51; 95% confidence interval, 0.29–0.91). After further adjustment, the multivariable-adjusted hazard ratio was 0.57 (95% confidence interval, 0.32–1.02) for snus quitters versus continuing users. The corresponding estimate for those who quit versus continued smoking post-MI was 0.54.
"In this study, discontinuation of snus use after an MI was associated with a nearly halved mortality risk, similar to the benefit associated with smoking cessation," the authors write. "These observations suggest that the use of snus after MI should be discouraged."