Cardiovascular disease outcomes among established cigar users 40 years and older: Findings from the population assessment of tobacco and health (PATH) study, waves 1-5 (2013-2019)

Eva Sharma; Zhiqun Tang; Kristin Lauten; Marushka L Silveira; Cristine D Delnevo; Kathryn C Edwards; Daniela Marshall; Diann E Gaalema; Izabella Zandberg; Bria Graham-Glover; Derick L Rivers; Omoye E Imoisili; Kirstie Neal; Raymond Niaura; Maansi Bansal-Travers; Andrew Hyland; K Michael Cummings

doi:10.1016/j.pmedr.2023.102569

Cardiovascular disease outcomes among established cigar users 40 years and older: Findings from the population assessment of tobacco and health (PATH) study, waves 1-5 (2013-2019)

Prev Med Rep. 2023 Dec 19:37:102569. doi: 10.1016/j.pmedr.2023.102569. eCollection 2024 Jan.

Authors

Eva Sharma¹, Zhiqun Tang¹, Kristin Lauten¹, Marushka L Silveira^{2

3}, Cristine D Delnevo⁴, Kathryn C Edwards¹, Daniela Marshall^{5

6}, Diann E Gaalema⁷, Izabella Zandberg⁸, Bria Graham-Glover⁸, Derick L Rivers⁸, Omoye E Imoisili⁸, Kirstie Neal⁸, Raymond Niaura⁹, Maansi Bansal-Travers¹⁰, Andrew Hyland¹⁰, K Michael Cummings¹¹

Affiliations

¹ Westat, Rockville, MD, USA.
² National Institute of Dental and Craniofacial Research, National Institutes of Health, Bethesda, MD, USA.
³ Kelly Government Solutions, Rockville, MD, USA.
⁴ Rutgers Center for Tobacco Studies, Rutgers Biomedical and Health Sciences, Rutgers University, New Brunswick, NJ, USA.
⁵ National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD, USA.
⁶ Axle Informatics, Rockville, MD, USA.
⁷ Department of Psychiatry, University of Vermont, Burlington, VT, USA.
⁸ Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD, USA.
⁹ Department of Social and Behavioral Sciences, NYU College of Global Public Health, New York University, NY, USA.
¹⁰ Department of Health Behavior, Division of Cancer Prevention & Population Sciences, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA.
¹¹ Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.

Abstract

This study examined associations between established cigar use and prevalence and incidence of cardiovascular diseases (CVD; congestive heart failure, stroke, or heart attack/needed bypass surgery) among U.S. adults, 40 years or older. Using Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health (PATH) Study, incidence (N_individuals (N_ind) = 6,692; N_observations (N_obs) = 23,738) and prevalence (N_ind = 7,819; N_obs = 33,952) of CVD outcomes were examined using weighted generalized estimating equations (WGEEs) among adults who were exclusive current/former established cigar smokers (ever cigar smokers who have smoked fairly regularly), exclusive current/former established cigarette smokers (lifetime smokers of 100 or more cigarettes), dual current/former established cigarette and cigar smokers compared with never smokers of cigars or cigarettes, adjusting for covariates. The population-averaged incidence of CVD from one wave to next among exclusive current/former established cigar smokers during a six-year period based on WGEEs was low (overall average rate of 3.0 %; 95 % CI: 1.2, 7.0). Compared with never users, exclusive current/former established cigar smokers (OR = 1.67, 95 % CI: 1.11, 2.51) and exclusive current/former established cigarette smokers (OR = 2.12, 95 % CI: 1.45, 3.09) were more likely to have any CVD outcome in unadjusted analyses. When adjusted for covariates, only exclusive current/former established cigarette use was associated with CVD outcomes (AOR = 1.60, CI: 1.07, 2.40). Results suggest that exclusive established use of cigars or duration of exclusive cigar use was not associated with lifetime CVD prevalence compared with never cigar or cigarette smokers, which is important in understanding health outcomes in cigar users.

Keywords: Adults; Cardiovascular disease outcomes; Cardiovascular risk factors; Cigar use; Cigar use duration.