Search

Background: The purpose of this study was to examine the association between established cigar use and prevalence and incidence of cardiovascular diseases (CVD; congestive heart failure, stroke, or heart attack/needed bypass surgery) among U.S. adults, 40 years or older. The study also explored if years of use, is associated with CVD prevalence. Methods: Using Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health (PATH) Study, a nationally representative, longitudinal cohort study of U.S. adults and youth, pooled prevalence, restricted to adults 40 and older who provided data at every wave (N=10,128 unique respondents and Nobs=46,294;), was estimated to understand the association between established cigar use and self-reported CVD outcomes. Weighted generalized estimating equations were used to examine CVD outcomes among exclusive current/former established cigar smokers (ever cigar smokers who have smoked fairly regularly), exclusive current/former established cigarette smokers (lifetime smokers of 100 or more cigarettes), dual current/former established cigarette and cigar smokers compared to never smokers of cigars or cigarettes, adjusting for covariates. Results: The incidence of CVD among exclusive current/former established cigar smokers over a six-year period was low (overall average rate of 3.0%). The pooled-prevalence of CVD outcome was very similar among exclusive current/former established cigar smokers (10.7%; 95% CI: 7.0-16.1) and exclusive current/former established cigarette smokers (10.7%; 95% CI: 9.4-12.2) and slightly higher among dual users of cigars and cigarettes (14.3%; 95% CI: 11.8-17.1). Compared to never users, exclusive current/former established cigar smokers (OR = 1.67, 95% CI: 1.11-2.51) and exclusive current/former established cigarette smokers (OR = 2.12, 95% CI: 1.45-3.09) were more likely to have any CVD outcome in unadjusted analyses. When adjusted for covariates, only exclusive current/former established cigarette use was associated with CVD outcomes (AOR = 1.63, CI: 1.05-2.53). We did not find a consistent dose response relationship between duration of exclusive current/former established cigar use and CVD prevalence. Conclusions: Understanding how cigar use impacts CVD is important in reducing tobacco-related mortality and morbidity. In this study, exclusive established use of cigars or duration of exclusive cigar use was not associated with CVD prevalence compared to never cigar or cigarette smokers.