Source: HeartWire Author: Steve Stiles London, UK - Tobacco use significantly ups the risk of nonfatal MI independently of its varied methods around the world and whether exposure is direct or through second-hand smoke, according to INTERHEART, a large, broadly international case-control study [1]. The findings sharpen and add a global perspective to the massive epidemiologic evidence implicating smoking and other tobacco uses as causes of heart disease. The analysis, which appears in the August 19, 2006 issue of the Lancet, suggests that current cigarette smoking confers nearly triple the adjusted MI risk faced by persons who have never smoked and that the hazards can't be escaped by resorting to other forms of tobacco use. The study looked at the effects of not only smokeless tobacco but also less common modes of smoking, including some that are primarily limited to specific geographic regions such as South and Central Asia. "Our findings show that tobacco in any form is harmful," write the authors, Dr Koon K Teo (McMaster University-Hamilton Health Sciences, Hamilton, ON) and associates. Other noteworthy observations include a significant dose-response relationship between the number of cigarettes consumed daily and the likelihood of MI, even at only a few cigarettes per day. Commenting on the study for heartwire, Dr Ira S Ockene (University of Massachusetts Medical School, Worcester) said that it replicates much earlier work but "adds so much more," including a global perspective not only geographically but in terms of spanning virtually all forms of tobacco exposure. Its data on the risks of chewing [...]