Prospective study on tobacco smoking and the risk of cardiovascular disease among adults in Hainan Province

Objective To explore the relationship between tobacco smoking and risk of cardiovascular diseases in adults in Hainan province. Methods The present analysis included 28 940 participants from the China-UK cooperation project "China Kadoorie Biobank" after excluding those with coronary heart diseases, stroke and cancer at baseline survey. The participants were permanent residents of Hainan province, aged between 30 and 79. Cox regression analysis was used to calculate the cardiovascular disease risk hazard ratios and 95% CI of nonsmokers, ex—smoker and current smokers. Results During a median follow-up of 6.2 years (a total of 177 279 person years), 1 310 men and 2 200 women developed the disease. The smoking rate of men (47.0%) was much higher than that of women (0.3%). After adjustment for multiple covariates, smoking increased risk of all subtypes of cardiovascular diseases. Compared with nonsmokers, the multivariable-adjusted HRs (95% CI) for current smokers were 1.63 (1.12-2.38) for acute coronary heart disease, 1.24 (1.04-1.47) for ischemic heart disease, respectively. Among current smokers, those who smoked more than 30 cigarettes a day had the highest risk of acute coronary heart disease, ischemic stroke and hemorrhagic stroke. Conclusion This prospective study confirms increased risk of all subtypes of cardiovascular diseases in smokers. Smoking cessation targets and smoking control measures should be established for smokers based on the risk of different cardiovascular diseases.