Smokeless Tobacco Increases Risk for Fatal MI and Fatal Stroke

To determine whether smokeless tobacco (chewing tobacco and snuff) is a risk factor for myocardial infarction, researchers performed a meta-analysis of 11 observational studies from the U.S. and Sweden. Two studies included former smokers, and the remainder included only subjects who had never smoked; all but one study included only men.

Among those who had ever used smokeless tobacco, compared with those who had never used it, the relative risk for fatal MI (assessed in 8 studies) was 1.13, and the relative risk for fatal stroke (assessed in 5 studies) was 1.40. Results from studies conducted in the U.S. and Sweden were consistent.