Association between cigarette smoking status, intensity, and cessation duration with long-term incidence of nine cardiovascular and mortality outcomes: The Cross-Cohort Collaboration (CCC)

作者：Erfan Tasdighi, Zhiqi Yao, Zeina Dardari, Kunal Jha, Ngozi Osuji, Tanuja Rajan, Ellen Boakye, Kunihiro Matsushita, Eleanor M. Simonsick, João A.C. Lima, Donald M. Lloyd‐Jones, Debbie L. Cohen, Lawrence J. Appel, Amit Khera, Michael E. Hall, Carlos J. Rodríguez, Suzanne E. Judd, Shelley A. Cole, Ramachandran S. Vasan, Emelia J. Benjamin, Paulo A. Lotufo, Márcio Sommer Bittencourt, Samar R. El Khoudary, Rebecca C. Thurston, Carol A. Derby, Bruce M. Psaty, Charles B. Eaton, Michael J. LaMonte, Peggy M. Cawthon, Eric Orwoll, Aruni Bhatnagar, Andrew P. DeFilippis, Michael J. Blaha · 发表于：PLoS Medicine · 年份：2025 · DOI：10.1371/journal.pmed.1004561 · 被引用次数：14 · 研究领域：Smoking Behavior and Cessation、Cardiovascular Health and Risk Factors、Blood Pressure and Hypertension Studies

BACKGROUND: Uncertainties persist regarding the precise shape of the smoking-outcome curves across various cardiovascular and mortality endpoints. This study aims to elucidate the relationships among smoking burden, intensity, and cessation duration across multiple cardiovascular outcomes. METHODS AND FINDINGS: Cox proportional hazard models were constructed to evaluate the association between pack-years, cigarettes per day (CPD), and years since cessation with cardiovascular outcomes in participants from 22 prospective cohort studies within the Cross-Cohort Collaboration Tobacco Working Group. We evaluated myocardial infarction (MI), stroke, coronary heart disease (CHD; MI, coronary revascularization, or coronary death), cardiovascular disease (CVD; stroke or cardiovascular death), heart failure (HF), atrial fibrillation (AFib), CHD mortality, CVD mortality, and all-cause mortality. Median follow-up varied across outcomes, with 14.4 years for MI (17,570 events), 19.3 years for CHD (30,625 events), 18.6 years for CVD (54,078 events), and approximately 19.4-19.9 years for mortality outcomes (CHD mortality: 17,429 events; CVD mortality: 33,120 events; all-cause mortality: 125,044 events). Spline terms were used to investigate the nonlinear association of continuous smoking/cessation measures with the examined outcomes. Models were adjusted for demographic, socioeconomic, and other cardiovascular risk factors. The study included 323,826 adults (148,635 non-mortality and 176,396 ...