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Bidi and cigarette smoking and risk of acute myocardial infarction among males in urban India
  1. T Rastogi1,
  2. P Jha2,
  3. K S Reddy3,
  4. D Prabhakaran3,
  5. D Spiegelman4,
  6. M J Stampfer5,
  7. W C Willett5,
  8. A Ascherio5
  1. 1Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts, USA
  2. 2Public Health Sciences, University of Toronto, Toronto, Canada
  3. 3All India Institute of Medical Sciences, New Delhi, India
  4. 4Departments of Biostatistics and Epidemiology, Harvard School of Public Health
  5. 5Departments of Nutrition and Epidemiology, Harvard School of Public Health
  1. 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;


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.

  • bidi smoking
  • cigarette smoking
  • coronary heart disease
  • myocardial infarction
  • India

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  • Competing interests: none declared

  • Study design and data collection were done by TR, AA, WCW, KSR, DP, DS. Data analysis and interpretation were done by TR, PJ, AA, WCW, MJS, DS. Manuscript preparation was done by TR and PJ with critical feedback on the manuscript provided by AA, WCW, MJS, KSR, DP, DS.