The Risk of Myocardial Infarction after Quitting Smoking in Men under 55 Years of Age

• Published in: The New England journal of medicine Vol. 313; no. 24; pp. 1511 - 1514
• Main Authors: Rosenberg, Lynn, Kaufman, David W, Helmrich, Susan P, Shapiro, Samuel
• Format: Journal Article
• Language: English
• Published: Boston, MA Massachusetts Medical Society 12.12.1985
• Subjects: Adult; Age; Age Factors; Angina pectoris; Biological and medical sciences; Cardiology. Vascular system; Cardiovascular disease; Cigarettes; Confidence intervals; Coronary heart disease; Epidemiology; Estimates; Family medical history; Health risk assessment; Heart; Heart attacks; Humans; Interviews; Male; Medical sciences; Mens health; Middle Aged; Mortality; Myocardial Infarction - epidemiology; Pain; Risk; Smoking; Smoking Prevention; Time Factors; Vasectomy; Human; Statistical analysis; Weanling; Infarct; Young adult; Risk factor; Tobacco smoking; Myocardium; Cardiovascular disease; Poisoning; Coronary heart disease
• ISSN: 0028-4793; 1533-4406
• DOI: 10.1056/NEJM198512123132404

We assessed the effect of quitting cigarette smoking on the incidence of nonfatal myocardial infarction in men under the age of 55 in a case–control study of 1873 men with first episodes of myocardial infarction and 2775 controls. For "current" smokers (men who had smoked in the previous year) as compared with those who had never smoked, the estimated relative risk of myocardial infarction, adjusted for age, was 2.9 (95 per cent confidence interval, 2.4 to 3.4). Among exsmokers (those who had last smoked at least one year previously), the relative-risk estimate declined to a value close to unity for those who had abstained for at least two years; the estimate was 2.0 (1.1 to 3.8) for men who had abstained for 12 to 23 months, and the estimates were about 1.0 for men who had abstained for longer intervals. The results were unchanged by allowance for multiple potential confounding factors. A similar pattern was apparent among exsmokers who had smoked heavily for many years; among those predisposed to a myocardial infarction because of family history, hypertension, or other risk factors; and among those with no apparent predisposition. The results suggest that the risk of myocardial infarction in cigarette smokers decreases within a few years of quitting to a level similar to that in men who have never smoked. (N Engl J Med 1985; 313:1511–4.) CIGARETTE smoking is a major cause of myocardial infarction 1 ; smokers have been encouraged to quit, and many have done so. Previous studies have suggested that exsmokers eventually have an incidence of myocardial infarction similar to that of people who have never smoked, 2 3 4 5 6 7 8 9 10 11 but they have generally not taken into account predisposing factors, nor have they established how soon the risk declines, particularly among those predisposed to an infarction for other reasons. These issues are addressed in the present report, with data from a large study of first episodes of nonfatal myocardial infarction in men under 55 years of age. . . .