How broadly does smoking raise heart and vessel disease risk?
In a large Australian cohort, current smoking raised risk across nearly all CVD subtypes—especially peripheral arterial disease—and quitting lowered risk.
Source
Tobacco smoking and risk of 36 cardiovascular disease subtypes: fatal and non-fatal outcomes in a large prospective Australian study
Study at a glance
- Design
- Cohort — 45 and Up Study; current and past vs never smokers for fatal/non-fatal CVD subtypes
- N
- N=188167 · Analysis dataset 188,167 participants; 27,511 major CVD events over 1.35 million person-years
- Population
- Australian adults in the 45 and Up Study
- Outcome
- Hospitalisation or death from major CVD subtypes by smoking status
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How broadly does smoking raise heart and vessel disease risk?
These passages occur verbatim in the stored paper text. They support the points listed below; they do not verify every statement in the explanation.
What happens with quitting according to authors?
Quitting reduces the risk.
Which cohort supplied participants?
The Sax Institute’s 45 and Up Study is a cohort study of 267,153 men and women aged 45 and over at baseline, randomly sampled from the general population of New South Wales (NSW), Australia, using the Department of Human Services enrolment database.
What they did
Using the 45 and Up Study with 1.35 million person-years of follow-up, investigators compared current and past smokers with never smokers for dozens of fatal/non-fatal CVD subtypes.
What they found
Among 27,511 major CVD events, current smoking elevated risks for IHD/AMI, stroke, heart failure, and especially PAD (RR ~5). Risks were intermediate in former smokers; quitting reduces risk. Even paroxysmal tachycardia risk was implicated.
The limits
What it doesn't show
Observational residual confounding is possible despite adjustment; subtype risks vary and are not identical.
Key terms
- CVD subtypes
- Distinct cardiovascular diagnoses such as AMI, stroke, heart failure, and PAD.
- Current vs never smoker
- Comparison of people smoking at baseline versus those who never smoked.
- Peripheral arterial disease
- Atherosclerotic disease of limb arteries, highly smoking-related here.
- Smoking-attributable risk
- Disease burden theoretically linked to tobacco use.
- 45 and Up Study
- Large prospective cohort of Australian adults.
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Major CVD events numbered about:
Common questions
How many major CVD events?
27,511 fatal and non-fatal events.
Which subtype had especially high RR?
Peripheral arterial disease (about fivefold).
Do former smokers look like never smokers?
Risks were intermediate—quitting helps but history matters.
New signal mentioned?
Increased risk of paroxysmal tachycardia.
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