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The Science to Inform a Tobacco Product Standard for the Level of Nicotine in Combusted Cigarettes

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Higher taxes show way to cut smoking in Hong Kong

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THE TRUE COST OF TOBACCO

This week, the World Bank will release its Human Capital Index. This index rates countries on how close they are to having a healthy, educated workforce that is prepared for the more highly-skilled jobs of the future; and to compete effectively in the global economy.

The health and economic costs of tobacco are clear: it kills more than seven million people every year and millions more suffer from tobacco-related disease – often during their most economically productive years. The global economic cost of smoking amounts to nearly 2 trillion dollars annually, almost 2 per cent of the world’s GDP.

The tobacco industry pushes a narrative about its own economic contribution as an obstacle to the implementation of tobacco control policies. The true cost of tobacco is to be found in the stories of suffering told by the victims like Ike, a non-smoking mother of two from Indonesia, who developed throat cancer from second-hand smoke exposure, or Sunita, a 27-year old smokeless tobacco user from India, who never smoked but developed fatal oral cancer.

The FCTC and the ITP are solutions to reducing tobacco’s harm. If they are properly implemented, cost savings from improved health and productivity, and increased taxes, can fund investments in a country’s human capital and save lives.

Vital Strategies

The male fertility crisis continues: Quality of sperm plummets

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The devastating effects of smoking

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Parental tobacco use and child death

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Revolution or redux? Assessing IQOS through a precursor product

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Smoking May Boost Irregular Heart Beat Risk

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The more you smoke, the greater your risk of a heart rhythm disorder

European Society of Cardiology

https://www.eurekalert.org/pub_releases/2018-07/esoc-tmy071118.php

The more you smoke, the greater your risk of a heart rhythm disorder called atrial fibrillation. That’s the finding of a study published today in the European Journal of Preventive Cardiology, a European Society of Cardiology (ESC) journal.(1)

The study found a 14% increase in the risk of atrial fibrillation for every ten cigarettes smoked per day. There was a linear dose-response relationship, meaning that the risk increased with each additional cigarette smoked.

Compared to people who had never smoked, current smokers had a 32% increased risk of atrial fibrillation, while ever smokers (current and former smokers combined) had a 21% increased risk, and former smokers had a 9% increased risk – providing further evidence of a dose-response relationship.

“If you smoke, stop smoking and if you don’t smoke, don’t start,” said study author Dr Dagfinn Aune, postdoctoral researcher at Imperial College London, UK, and associate professor at Bjørknes University College in Oslo, Norway. “We found that smokers are at increased risk of atrial fibrillation, but the risk is reduced considerably in those who quit.”

Smoking is a lethal addictive disorder.(2) A lifetime smoker has a 50% probability of dying due to smoking, and on average will lose ten years of life. Slightly less than half of lifetime smokers will continue smoking until death. The rate of smoking is declining in Europe, but it is still very common and is increasing in women, adolescents and the socially disadvantaged.

Atrial fibrillation is the most common heart rhythm disorder (arrhythmia). It causes 20-30% of all strokes and increases the risk of dying prematurely.(3) One in four middle-aged adults in Europe and the US will develop atrial fibrillation. It is estimated that by 2030 there will be 14-17 million patients with atrial fibrillation in the European Union, with 120,000-215,000 new diagnoses each year.

Few studies have assessed whether there is a dose-response relationship between the number of cigarettes smoked and the risk of atrial fibrillation. The authors of the current study investigated this issue by conducting a meta-analysis of 29 prospective studies from Europe, North America, Australia and Japan with a total of 39,282 incident cases of atrial fibrillation among 677,785 participants.

Compared to zero cigarettes per day, smoking five, ten, 15, 20, 25 and 29 cigarettes per day was associated with a 9%, 17%, 25%, 32%, 39%, and 45% increased risk of atrial fibrillation, respectively.

Every ten pack-years of smoking was associated with a 16% increased risk of developing atrial fibrillation. Pack-years are calculated by multiplying the number of packs of cigarettes smoked per day by the number of years the person has smoked.

European guidelines on the prevention of cardiovascular disease recommend avoiding tobacco in any form.2 All types of smoked tobacco, including low-tar (“mild” or “light”) cigarettes, filtered cigarettes, cigars, pipes, and water pipes are harmful.

Dr Aune said: “Our results provide further evidence of the health benefits of quitting smoking and, even better, to never start smoking in the first place. This is important from a public health perspective to prevent atrial fibrillation and many other chronic diseases.”

Dr Aune noted that more research is needed to identify the duration of smoking cessation needed to reduce the risk of atrial fibrillation, and whether the risk at some point reaches that of people who have never smoked.

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Authors: ESC Press Office
Tel: +33 (0)4 8987 2499
Mobile: +336 (0) 2314 5784
Email: press@escardio.org

SOURCES OF FUNDING: See the paper for a list of funding sources.

DISCLOSURES: None.

References

(1) Aune D, Schlesinger S, Norat T, Riboli E. Tobacco smoking and the risk of atrial fibrillation: A systematic review and meta-analysis of prospective studies. European Journal of Preventive Cardiology. 2018. DOI: 10.1177/2047487318780435.
(2) Piepoli MF, Hoes AW, Agewall S, et al. 2016 European Guidelines on cardiovascular disease prevention in clinical practice. European Heart Journal. 2016;37:2315-2381.
(3) Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. European Heart Journal. 2016;37:2893-2962. https://academic.oup.com/eurheartj/article/37/38/2893/2334964

About the European Society of Cardiology

The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.

About the European Journal of Preventive Cardiology

The European Journal of Preventive Cardiology is the world’s leading preventive cardiology journal, playing a pivotal role in reducing the global burden of cardiovascular disease.

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