Vaping just as bad for PAD risks as smoking, maybe

[Eddy Edson]

Big, long-term observational study. Because the study period started before the era of vaping it only looked at snuff and chewing tobacco, but the authors are pretty sure the result would extend to vaping as well.

Association of Smokeless Tobacco Use With Incident Peripheral Artery Disease: Results From the Atherosclerotic Risk in Communities Study

Cigarette smoking is associated with an increased risk for peripheral artery disease. It is unknown whether smokeless tobacco, a noncombustible form of tobacco exposure, is also associated with increased peripheral artery disease risk. Using data from the Atherosclerosis Risk in Communities...

www.ajpmonline.org

Introduction​

Cigarette smoking is associated with an increased risk for peripheral artery disease. It is unknown whether smokeless tobacco, a noncombustible form of tobacco exposure, is also associated with increased peripheral artery disease risk. Using data from the Atherosclerosis Risk in Communities study, we tested the hypothesis that the use of smokeless tobacco is associated with a higher risk of developing peripheral artery disease.

Methods​

Participants with peripheral artery disease at baseline were excluded. Smokeless tobacco use was assessed 3 times from 1987 to 1995, and peripheral artery disease events accrued from 1987 to 2018. Smokeless tobacco was modeled as a time-dependent exposure in Cox regression models. Analyses were completed in 2021.

Results​

This study included 14,344 participants with a baseline mean (SD) age of 54.1 (5.7) years; 54.8% were female, and 26.4% were Black. There were 635 incident peripheral artery disease events over a median follow-up of 27.6 years (maximum of 32.1 years). The peripheral artery disease incidence rate was 4.44 per 1,000 person-years among those who used smokeless tobacco compared with 1.74 per 1,000 person-years for those who did not. The hazard ratio for current versus never smokeless tobacco use was 1.94 (95% CI=1.31, 2.88) after adjustment for sociodemographic characteristics and cigarette smoking. Peripheral artery disease incidence rate among those currently using smokeless tobacco was similar to that of those who currently smoke cigarette (3.39 per 1,000 person-years).

Conclusions​

Current smokeless tobacco use was associated with high rates of peripheral artery disease, similar to cigarette smoking. Future research should evaluate the effect of cessation of noncombustible tobacco on incident peripheral artery disease.

.....

Our definition of smokeless tobacco was limited to chewing tobacco and snuff because these were the main smokeless methods in the late 1980s when ARIC started. However, smokeless tobacco can be viewed as an analog to E-cigarette products because neither involves combustion in their use. Noncombustible nicotine and tobacco products have been perceived as clean nicotine delivery systems and therefore less harmful than cigarette smoking, leading some to advocate for their use to help with cigarette cessation. The U.S. Food and Drug Administration recently authorized the marketing of some tobacco-flavored E-cigarette products to aid cessation efforts while denying others.

Uncertainty about the net benefit versus harm of E-cigarettes remains.
This study adds to the growing body of research showing the CVD risk associated with some forms of noncombustible nicotine and tobacco exposure.

Additional research should specifically examine the risk of PAD associated with contemporary forms of noncombustible tobacco, particularly E-cigarettes, and evaluate whether cessation of noncombustible tobacco reduces PAD risk.

 

[Barrowman]

Thanks for posting that link @Eddy Edson an interesting read.

 

[Satan’s little helper]

Now interestingly. I had this theory on vaping. During an autopsy some guy will cut open a cadaver, (with a vaping history.) turn to a colleague & exclaim, “my word, if I didn’t know any better I’d say this person died by drowning.!”

But that’s just a wild guess on my part.