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Is there any association between use of smokeless tobacco products and coronary heart disease in Bangladesh?

Rahman, Muhammad Aziz, Spurrier, Nicola, Mahmood, Mohammad Afzal, Rahman, Mahmudur, Choudhury, Sohel Reza and Leeder, Stephen 2012, Is there any association between use of smokeless tobacco products and coronary heart disease in Bangladesh?, PLoS one, vol. 7, no. 1, pp. 1-11, doi: 10.1371/journal.pone.0030584.

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Title Is there any association between use of smokeless tobacco products and coronary heart disease in Bangladesh?
Author(s) Rahman, Muhammad AzizORCID iD for Rahman, Muhammad Aziz
Spurrier, Nicola
Mahmood, Mohammad Afzal
Rahman, Mahmudur
Choudhury, Sohel Reza
Leeder, Stephen
Journal name PLoS one
Volume number 7
Issue number 1
Article ID e30584
Start page 1
End page 11
Total pages 11
Publisher Public Library of Science
Place of publication San Francisco, Calif.
Publication date 2012
ISSN 1932-6203
Keyword(s) Adult
Coronary Artery Disease
Middle Aged
Risk Factors
Tobacco, Smokeless
Summary BACKGROUND: Most epidemiological studies exploring the association between smokeless tobacco (SLT) use and coronary heart disease (CHD) have been in Western populations, and have focused on SLT products used in those countries. Few studies come from South Asian countries. Our objective was to determine the association between SLT use and CHD among non-smoking adults in Bangladesh.
METHODS: A matched case-control study of non-smoking Bangladeshi adults aged 40-75 years was conducted in 2010. Incident cases of CHD were selected from two cardiac hospitals. Community controls, matched to CHD cases, were selected from neighbourhoods, and hospital controls were selected from outpatient departments of the same hospitals. The Rose Angina Questionnaire (RAQ) was also used to re-classify cases and controls.
RESULTS: The study enrolled 302 cases, 1,208 community controls and 302 hospital controls. Current use was higher among community controls (38%) compared to cases (33%) and hospital controls (32%). Current use of SLT was not significantly associated with an increased risk of CHD when community controls were used (adjusted OR 0.87, 95% CI 0.63-1.19), or when hospital controls were used (adjusted OR 1.00, 95% CI 0.63-1.60), or when both control groups were combined (adjusted OR 1.00, 95% CI 0.74-1.34). Risk of CHD did not increase with use of individual types except gul, frequency, duration, past use of SLT products, or using the RAQ to re-classify cases and controls. There was a significant association between gul use and CHD when both controls were combined (adjusted OR 2.93, 95% CI 1.28-6.70).
CONCLUSIONS: There was no statistically significant association between SLT use in general and CHD among non-smoking adults in Bangladesh. Further research on the association between gul use and CHD in Bangladesh along with SLT use and CHD in other parts of the subcontinent will guide public health policy and interventions that focus on SLT-related diseases.
Language eng
DOI 10.1371/journal.pone.0030584
Field of Research 110299 Cardiorespiratory Medicine and Haematology not elsewhere classified
Socio Economic Objective 920103 Cardiovascular System and Diseases
HERDC Research category C1.1 Refereed article in a scholarly journal
ERA Research output type C Journal article
Copyright notice ©2012, Rahman et al.
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Document type: Journal Article
Collections: School of Medicine
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