Smokeless tobacco products linked to heart attack risk

The American Heart Association released a policy statement today saying that long term use of smokeless tobacco products increases the risk of suffering a fatal heart attack,officially referred to as myocardial infarction. 

The AHA asserts that smokeless tobacco products should not be used as an alternative to cigarettes or for smoking cessation, due to the risk of addiction and/or a relapse back into actual smoking. 

According to the statement, which was published online in the official journal of the association, Circulation,  smokeless tobacco products, including dry and wet snuff and chewing tobacco, may also raise the odds of fatal heart attacks, fatal strokes and certain cancers. 

“No tobacco product is safe to consume,” said Mariann Piano, Ph.D., lead author of the policy statement and professor in the Department of Biobehavioral Health Science at the University of Illinois in Chicago. 

Use of smokeless tobacco products is due in part to the so-called Swedish experience; in that particular instance, the use of smokeless tobacco products decreased cigarette smoking in Swedish men between 1976 and 2002, the statement claims. 

The AHA says the United States has experienced the opposite result - that is, using smokeless tobacco products actually increased the smoking rates among users of smokeless tobacco. 

In any case, the AHA suggests, nicotine replacement therapy based on nicotine gum or a nicotine releasing patch, which has not been associated with heart attack or stroke, is a safer alternative to smokeless tobacco products. 

Studies have found that nicotine is not absolutely safe, as it can lead to some side effects. 

It should be noted that nicotine has been suspected to play a pathogenic role in the induction and progression of cardiovascular disorders, including cardiomyopathy and peripheral vascular disease. Nicotine alters the function of vascular endothelium; additionally, it initiates the adhesion cascade and stimulates the vascular inflammatory events which ultimately induces atherosclerosis and hypertension, Balakumar P and Kaur J at the University of Montreal in Quebec says in an article published in Pharmacological Research. 

“Smokeless tobacco products are harmful and addictive – that does not translate to a better alternative,” Piano said. 

The Food and Drug Administration was cited as issuing a final regulation related to the Tobacco Control Act, effective June 22, that prohibits the sale of tobacco products to anyone younger than 18 years. 

Smokeless tobacco products include dipping tobacco, chewing tobacco, snuff, snus, creamy snuff, tobacco gum, dissolvable tobacco, topical tobacco paste, and tobacco water, according to medical news today. 

One study reported in the Sep 1, 2010 issue of American Journal of Epidemiology found that current use of smokeless tobacco was associated with an increased risk of cardiovascular diseases, such as heart attack and stroke. 

Yatsuya H. and colleagues at the University of Minnesota analysed data from 14,498 men and women aged 45 to 64 years between 1987 and 1989 in the Atherosclerosis Risk in Communities (ARIC) Study and found users of smokeless tobacco were 1.27 times as likely as non-users to suffer myocardial infarction, coronary revascularization, coronary death or stroke. 

The researchers wrote in their report "Current users of smokeless tobacco should be informed of its harm and advised to quit the practice. Current cigarette smokers should also be given sufficient information on safe, therapeutic methods of quitting which do not include switching to smokeless tobacco." 

By David Liu - Editing by Rachel Stockton