Time for a Second Look: Are the “New Tobacco” Products Safer than in Years Past?
BACKGROUND AND PURPOSE:
There is data available on cigarette smoking and mortality, but limited information on other tobacco products such as pipes and cigars
12.5 million people in the United States aged 12 years or older are cigar smokers (2015)
Products such as cigars have evolved over time and more current research is needed
Christensen et al. (JAMA Internal Medicine, 2018) examined the mortality risks associated with current and former use of cigars, pipes, and cigarettes
Data subset from The National Longitudinal Mortality Study (NLMS)
Sample of the civilian, noninstitutionalized US population consisting of the Annual Social and Economic Supplements (March 1973 to March 2011) | Tobacco Use Supplement to the Current Population Survey (TUS-CPS) | Census data linked to mortality data from the National Death Index (through 2011)
Participants provided tobacco use information at baseline in surveys in 1985 and followed for mortality until end of 2011
Tobacco use classified as
Exclusive current or former use of cigarettes
Any cigar (little cigar, cigarillos, large cigar)
Never use tobacco
Current daily and nondaily use was also collected
Estimates were adjusted based on age, sex, race/ethnicity, education, and survey year
Primary outcome: All-cause and cause-specific mortality as identified as the primary cause of death from death certificate information
Data was collected from 375,420 participants
The majority of former cigar and pipe smokers were male (79.3-98.0%)
Smokers were more evenly divided by sex (54% female)
There were 51,150 deaths during follow-up
Compared to never tobacco users, both exclusive current cigarette smokers (hazard ratio [HR], 1.98; 95% CI, 1.93-2.02) and exclusive current cigar smokers (HR, 1.20; 95% CI, 1.03-1.38) had higher all-cause mortality risks
Exclusive current cigarette smokers (HR, 4.06; 95% CI, 3.84-4.29), exclusive current cigar smokers (HR, 1.61; 95% CI, 1.11-2.32), and exclusive current pipe smokers (HR, 1.58; 95% CI, 1.05-2.38) had an elevated risk of dying from the following tobacco-related cancers
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Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
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