Smokers in Västerbotten County, Sweden
What contributes to increased cardiovascular risk among heavy smokers?

Abstract

Increased cardiovascular disease (CVD) risk among heavy smokers may not just be the result of a direct toxic effect.

• Heavy smokers show a non-favourable pattern in serum lipids and in glucose metabolism.

• Heavy smokers are less physically active than never smokers.

Objective – To analyse risk factor levels and risk factor patterns among heavy smokers compared to never smokers. Design – An incident case-referent study. Setting – The study was nested within the Västerbotten Intervention Programme (VIP). Subjects – 286 people (62 women and 224 men) claimed to be heavy smokers, i.e. smoked 25 cigarettes or more per day. For each of them, two referents (who reported never to have been smokers) were matched on age and gender (572 referents). Main outcome measures – Differences in biomedical variables and social and lifestyle factors were confirmed. Results – S-cholesterol, s-triglycerides, fasting blood glucose, body weight and body mass index were all significantly elevated among the heavy smokers. Some gender differences were also found. Social and lifestyle factors differed significantly between heavy smokers and never smokers, but without gender differences. Conclusions – Heavy smokers carry a risk factor pattern corresponding to an increased risk of developing cardiovascular disease. Unfavourable changes in serum lipids and in glucose metabolism can exacerbate other deleterious effects of tobacco smoke on the cardiovascular system. Obviously, heavy smokers and never smokers differ not only in regard to biomedical variables but also to lifestyle and social health determinants. These are important factors to consider in public health efforts aimed at reducing the increased risk for cardiovascular diseases among smokers.

• biomedical risk factors
• cardiovascular disease
• cigarette smoking
• lifestyle factors
• social factors