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

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:
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

ABSTRACT
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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