Quitting Smokeless Tobacco Cuts Mortality Risk After Heart Attack

Reduced risk for those who quit snus found to be similar to that for smoking cessation

TUESDAY, June 24, 2014 (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, M.D., 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 younger than 75 years) were admitted to a coronary care unit for an MI from 2005 to 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 percent confidence interval, 0.29 to 0.91). After further adjustment, the multivariable-adjusted hazard ratio was 0.57 (95 percent confidence interval, 0.32 to 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."

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