[Tobacco, mortality and morbidity of atherosclerotic cardiovascular diseases--a prospective study in Paris].

In the Paris Prospective Study, after a 6,5 year follow-up, mortality and atherosclerotic disease incidence are studied according to the tobacco consumption measured at entry among 7746 middle-aged men in the same administrative group. Mortality is 3 times higher among smokers; the excess mortality of smokers concerns particularly cancers, especially cancers of the upper part of the digestive tube or lung cancers and coronary heart disease. The incidences of leg atherosclerosis and of hard coronary diseases increase very much with the quantity smoked and inhaled. The cigarette consumption is linked with the development of coronary diseases independently of other risk factors; it is taken into account in a five risk factor combination which gives the best estimation of individual risk of future disease. The theoretical effects of the reduction of cigarette consumption on the individual risk or on the incidence of coronary diseases are given. A multifactorial prevention with a small reduction of the level of several risk factors might reduce that incidence in the population.