Table 3.

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

	Use of Smokeless Tobacco
	Never User	Past User	Current User
Cigarette nonsmokers
No. of cases/total no.	1,510/9,906	112/494	102/354
Incidence rateb	9.8	16.0	21.0
Hazard ratioc (95% CI)	1 (referent)	0.90 (0.73, 1.11)	1.31 (1.06, 1.61)
Current cigarette smokers
No. of cases/total no.	760/3,401	59/241	29/102
Incidence rate	16.1	18.3	22.9
Hazard ratio (95% CI)	1 (referent)	0.86 (0.65, 1.13)	1.09 (0.74, 1.60)

Abbreviation: CI, confidence interval.

^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.

^cHazard ratios were adjusted for age, sex, race-center, educational level, total annual household income, usual alcohol consumption, physical activity, never or past cigarette smoking (in cigarette nonsmokers), pack-years of smoking, past and current use of pipes and cigars, and secondhand smoke exposure (hours/week).