DOI: http://dx.doi.org/10.18203/2349-3933.ijam20190452

Impact of smokeless tobacco products on myocardial infarction and stroke and it’s prognostic significance

Rajesh Ranjan Behera, Rajesh Padhi

Abstract


Background: The use of smokeless tobacco (SLT) predates smoking and its effects on the health of the individuals is very much similar tobacco smoking. The present study was done with the aim to find out independent prognostic significance of ST products on disease outcome like myocardial infarction and stroke.

Methods: This prospective study was done on the patients attending to the Department of Internal Medicine, Institute of Medical Sciences and SUM Hospital, Bhubaneswar with complaints suggesting of coronary artery disease and stroke during the period from July 2016 to June 2018. The exposure of risk factors and confounding factors are detailed and collected from the patients by using predesigned questionnaire. All the data was analysed by using SPSS version 20.

Results: During the study period a total of 423 patients were included in the study. Mean average age of the participants was 56.58±11.23 years. Male preponderance was seen in the study. Out of total patients, myocardial infarction was noticed in 49 and stroke in 64 patients. SLT was used by 323 (76.4%) users. Among SLT both gutkha and pan was most commonly used (55.6%). Among them hypertension and diabetes were seen in 193 and 184 patients respectively. Risk of incidence of CVA and stroke was found to be more among SLT users compared to non-users.

Conclusions: SLT is considered to be an important etiological factor for the incidence of myocardial infarction and stroke. There is an urgent need to increase clinical interventions and awareness in public to decrease SLT addiction.


Keywords


Cerebrovascular accident, Myocardial infarction, Smokeless tobacco

Full Text:

PDF

References


World Health Organization. WHO Report on the Global Tobacco Epidemic, 2011. Geneva: World Health Organization, 2011. Accessed 22 February 2018.

WHO report on the global tobacco epidemic, 2011. Available at: http://www.who.int/tobacco/global_report/2011/en/. Accessed 10 September 2018.

Gupta PC, Ray CS, Sinha DN, Singh PK. Smokeless tobacco: a major public health problem in the SEA region: a review. Ind J Pub Heal. 2011;55(3):199–209.

Gupta PC, Ray CS. Smokeless tobacco and health in India and South Asia. Respirol. 2003;8(4):419-31.

Pershagen G. Smokeless tobacco. Brit Med Bull. 1996;52(1):50–7.

Piano MR, Benowitz NL, FitzGerald GA, Corbridge S, Heath J, Hahn E, et al. Impact of smokeless tobacco products on cardiovascular disease: implications for policy, prevention, and treatment: a policy statement from the American Heart Association. Circulation. 2010;122(15):1520–44.

Gupta PC. Smokeless tobacco use, birth weight and gestational age: population based, prospective cohort study of 1217 women in Mumbai, India. BMJ. 2004;328(7455):1538–10.

Public health: a global perspective. national cancer institute. centers for disease control and prevention. U.S. Bethesda, MD: U.S. Department of Health and Human Services. Centers for disease control and prevention and national institutes of health, National Cancer Institute. NIH publication no. 14-7983; 2014.

Jena SS, Kabi S, Panda BN, Kameswari BC, Payal, Behera IC, et al. Smokeless tobacco and stroke - a clinico-epidemiological follow-up study in a Tertiary Care Hospital. J Clin Diagn Res. 2016;10(10):40-3.

Benowitz NL. Cigarette smoking and cardiovascular disease: pathophysiology and implications for treatment. Prog Cardiovasc Dis. 2003;46:91-111.

Boffetta P, Straif K. Use of smokeless tobacco and risk of myocardial infarction and stroke: systematic review with meta-analysis. BMJ. 2009;339:3060.

Gupta BK, Kaushik A, Panwar RB, Chaddha VS, Nayak KC, Singh VB, et al. Cardiovascular risk factors in tobacco-chewers: a controlled study. J Assoc Physicians India. 2007;55:27-31.