Table 2.

Incidence Rates and Hazard Ratios for Cardiovascular Disease^a According to Use of Smokeless Tobacco (Chewing Tobacco or Snuff) and Cigarette Smoking, Atherosclerosis Risk in Communities Study, 1987–2005

	Total No.	No. of Cases	Incidence Rateb	Crude		Model 1c		Model 2d
				HR	95% CI	HR	95% CI	HR	95% CI
Use of smokeless tobacco
Never user	13,307	2,270	11.3	1	Referent	1	Referent	1	Referent
Past user	735	171	16.7	1.50	1.28, 1.75	0.90	0.77, 1.06	0.88	0.75, 1.04
Current user	456	131	21.4	1.95	1.63, 2.32	1.29	1.08, 1.55	1.27	1.06, 1.52
Cigarette smoking
Never smoker	6,201	875	9.0	1	Referent	1	Referent	1	Referent
Past smoker	4,553	849	12.5	1.40	1.28, 1.54	1.01	0.90, 1.12	0.99	0.89, 1.11
Current smoker	3,744	848	16.4	1.87	1.70, 2.06	1.47	1.30, 1.66	1.46	1.29, 1.66

Abbreviations: CI, confidence interval; HR, hazard ratio.

^aCardiovascular disease was defined as hospitalized myocardial infarction, fatal coronary heart disease, electrocardiogram-confirmed myocardial infarction, cardiac procedure, or stroke.

^bPer 1,000 person-years.

^cIn model 1, hazard ratios were adjusted for age, sex, race-center, educational level, total annual household income, usual alcohol consumption, physical activity, cigarette smoking status (never, past, or current smoker), pack-years of smoking, and use of smokeless tobacco.

^dModel 2 included all of the variables in model 1 plus past and current use of pipes and cigars and secondhand smoke exposure (hours/week).