Institute of Epidemiology II, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstädter Landstrasse 1, 85764 Neuherberg, Germany.
BMC Public Health. 2011 May 4;11:273. doi: 10.1186/1471-2458-11-273.
Cigarette smoking has been shown to be one of the most important risk factors for cardiovascular diseases. However, little is known about cumulative effects of daily tar and nicotine intake on the risk of incident myocardial infarction (MI) so far. To bridge this gap, we conducted an analysis in a large prospective study from Southern Germany investigating associations of daily tar and nicotine intake with an incident MI event.
The study was based on 4,099 men and 4,197 women participating in two population-based MONICA Augsburg surveys between 1984 and 1990 and followed up within the KORA framework until 2002. During a mean follow-up of 13.3 years, a number of 307 men and 80 women developed an incident MI event. Relative risks were calculated as hazard ratios (HRs) estimated by Cox proportional hazards models adjusted for cardiovascular risk factors.
In the present study, male regular smokers consumed on average more cigarettes per day than female regular smokers (20 versus 15) and had a higher tar and nicotine intake per day. In men, the MI risk compared to never-smokers increased with higher tar intake: HRs were 2.24 (95% CI 1.40-3.56) for 1-129 mg/day, 2.12 (95% CI 1.37-3.29) for 130-259 mg/day and 3.01 (95% CI 2.08-4.36) for ≥ 260 mg/day. In women, the corresponding associations were comparable but more pronounced for high tar intake (HR 4.67, 95% CI 1.76-12.40). Similar associations were observed for nicotine intake.
The present study based on a large population-based sample adds important evidence of cumulative effects of tar and nicotine intake on the risk of incident MI. Even low or medium tar and nicotine intake revealed substantial risk increases as compared to never-smokers. Therefore, reduction of tar and nicotine contents in cigarettes cannot be seen as a suitable public health policy in preventing myocardial infarction.
吸烟已被证实是心血管疾病最重要的危险因素之一。然而，目前对于每日焦油和尼古丁摄入量对心肌梗死（MI）事件风险的累积效应知之甚少。为了弥补这一空白，我们在德国南部进行的一项大型前瞻性研究中进行了分析，该研究调查了每日焦油和尼古丁摄入量与 MI 事件的关联。
该研究基于 1984 年至 1990 年期间参加 MONICA 奥格斯堡两项人群调查的 4099 名男性和 4197 名女性，随访至 2002 年的 KORA 框架内。在平均 13.3 年的随访期间，307 名男性和 80 名女性发生了 MI 事件。相对风险通过 Cox 比例风险模型计算，模型调整了心血管危险因素。
在本研究中，男性经常吸烟者每天比女性经常吸烟者平均多吸 20 支烟，每天摄入的焦油和尼古丁量更高。在男性中，与从不吸烟者相比，MI 风险随着焦油摄入量的增加而增加：每天摄入 1-129mg 的 HR 为 2.24（95%CI 1.40-3.56），每天摄入 130-259mg 的 HR 为 2.12（95%CI 1.37-3.29），每天摄入≥260mg 的 HR 为 3.01（95%CI 2.08-4.36）。在女性中，相应的关联相似，但高焦油摄入量的关联更为明显（HR 4.67，95%CI 1.76-12.40）。尼古丁摄入量也存在类似的关联。
本研究基于大型人群样本，提供了重要证据，表明焦油和尼古丁摄入量的累积效应与 MI 事件的风险有关。即使是低或中等焦油和尼古丁摄入量，与从不吸烟者相比，风险也显著增加。因此，降低香烟中的焦油和尼古丁含量不能被视为预防心肌梗死的合适公共卫生政策。
