BRIEF REPORT

Bidi and cigarette smoking and risk of acute myocardial infarction among males in urban India

T Rastogi¹, P Jha², K S Reddy³, D Prabhakaran³, D Spiegelman⁴, M J Stampfer⁵, W C Willett⁵, A Ascherio⁵

¹ Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
² Public Health Sciences, University of Toronto, Toronto, Canada
³ All India Institute of Medical Sciences, New Delhi, India
⁴ Departments of Biostatistics and Epidemiology, Harvard School of Public Health
⁵ Departments of Nutrition and Epidemiology, Harvard School of Public Health

Correspondence to:
Correspondence to:
Dr Tanuja Rastogi
National Cancer Institute, Division of Cancer Epidemiology & Genetics, Nutritional Epidemiology Branch, 6120 Executive Blvd, EPS 320, Rockville, MD 20852, USA; TRASTOGI{at}post.harvard.edu

Death from myocardial infarction (MI) in India is exacerbated by smoking of bidis or cigarettes. Smoking among 309 men with incident MI was compared to 618 age matched controls; 56% of the individuals with MI and 26% of controls were current smokers. Current smokers had a relative risk of 4.7 (95% confidence interval (CI) 3.2 to 6.9) compared to never smokers. Relative risks for smoking more than 10 cigarettes or 10 bidis daily were 9.1 (95% CI 4.7 to 17.7) and 8.1 (95% CI 4.3 to 15.3), respectively. It is estimated that smoking may cause 53% (95% CI 47% to 64%) of MIs among urban males in India.

Keywords: bidi smoking; cigarette smoking; coronary heart disease; myocardial infarction; India

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