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‘No safe level of smoking exists for cardiovascular disease,’ a BMJ study found

Smoking one cigarette a day increases CVD risk

BMJ 2018;360:j5855

Light smokers who smoke one cigarette a day have about half the risk of developing coronary heart disease (CHD) or suffering a stroke as those who smoke 20 a day, according to a new meta-analysis of 141 cohort studies.

Overall, men and women smoking, on average, one cigarette a day were 48% and 57% respectively more likely to develop CHD than nonsmokers. Men and women smoking an average of five cigarettes a day were 58% and 76% respectively more likely to develop CHD than nonsmokers. Men and women smoking, on average, 20 cigarettes a day were two (relative risk [RR] 2.04) and three [RR 2.84] times more likely to develop CHD respectively.

Based on within study comparisons, men smoking between one and five cigarettes a day had 46% and 57% respectively of the excess risk of CHD caused by smoking 20 cigarettes a day. Women smoking between one and five cigarettes a day had 31% and 43% respectively of the excess risk.

Men and women smoking, on average, one cigarette daily were 25% and 31% respectively more likely to suffer a stroke than nonsmokers. Men and women smoking, on average, five cigarettes daily were 30% and 44% more likely to have a stroke respectively. Smoking, on average, 20 cigarettes a day doubled the risk (RR 1.64 in men and 2.16 in women).


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