Review with meta-analysis relating North American,European and Japanese snus or smokeless tobacco use to major smoking-related diseases  

作　　者：Peter Nicholas Lee Katharine Jane Coombs Janette Susan Hamling 

机构地区：[1]Department of Medical Statistics and Epidemiology,P.N.Lee Statistics and Computing Ltd,Sutton SM25DA,Surrey,United Kingdom [2]Department of Medical Statistics and Epidemiology,RoeLee Statistics Ltd,Sutton SM25DA,Surrey,United Kingdom

出　　处：《World Journal of Meta-Analysis》2022年第3期130-142,共13页世界荟萃分析杂志

摘　　要：BACKGROUND While extensive information exists relating cigarette smoking to the risk of lung cancer,chronic obstructive pulmonary disease(COPD),ischaemic heart disease(IHD)or acute myocardial infarction(AMI),and stroke,far less information is available on risks from moist snuff(“snus”)or smokeless tobacco(ST)in United States/Canada,Europe or Japan.AIM To summarize data from the selected countries on risks of the four diseases associated with current ST or snus use.METHODS Publications in English in 1990-2020 were considered that,based on epidemiological studies in North America,Europe or Japan,estimated risks of lung cancer,COPD,IHD/AMI,or stroke according to use of ST or snus.The studies should involve at least 100 cases of the disease considered,and not be restricted to those with specific other diseases.Medline literature searches were conducted,selecting papers initially from examination of titles and abstracts,and then from full texts.Further papers were sought from reference lists in selected papers,reviews and meta-analyses.For each disease,relative risk estimates adjusted at least for age were extracted relating ST or snus use to risk,and combined using random-effects meta-analysis.The estimates were mainly for current vs.never or non-current use,but results for ever vs never use were also considered.RESULTS Seven publications reported results for ST use from six United States studies.The most useful results came from four studies which provided results for current vs.never use.Random-effects meta-analyses of these results showed an increased risk for each disease,clearest for lung cancer(relative risk 1.59,95%confidence interval 1.06-2.39,based on 4 estimates)and COPD(1.57,1.09-2.26,n=3),but also significant(at P<0.05)for IHD(1.26,1.10-1.45,n=4)and stroke(1.27,1.03-1.57,n=4).Also including results for ever vs.never use from two other studies increased the lung cancer estimate to 1.80(1.23-2.64,n=6),but had little effect on the other estimates.For snus,16 publications described results from 12 studies

关 键 词：Smokeless tobacco Moist snuff Lung disease Cardiovascular disease META-ANALYSIS REVIEW 

分 类 号：R54[医药卫生—心血管疾病]