Combined associations of Changes in Noncombustible Nicotine or Tobacco Product and Combustible Cigarette Use habits With Subsequent Short-Term Cardiovascular Disease Risk among South Korean Men: a Nationwide Cohort Study.

Introduction:
This text is a summary of a research article examining the association between changes in the use of combustible cigarettes (CCs) and noncombustible nicotine or tobacco products (NNTPs) and the risk of cardiovascular disease (CVD) in South Korean men. The study uses data from the Korean National health Insurance Service database to follow a large cohort over several years.

Key Points:

* The study included 5,159,538 men and followed them from 2014-2019.
* Participants were divided into groups based on their CC and NNTP use habits.
* The study found that CC and NNTP users had a lower risk of CVD compared to continual CC-only smokers.
* however, recent and long-term CC quitters with NNTP use had a higher risk of CVD compared to those who quit CCs without NNTPs.
* The study also found that NNTP use was associated with higher all-cause mortality, lung cancer, and COPD risk.
* The results suggest that NNTP use on CC quitting may lead to higher CVD risk than CC quitting without NNTPs.
* The study's limitations include the lack of information on the specific types of NNTPs used, the potential misclassification of smoking status, and the short follow-up duration.

Main Message:
This study suggests that switching to NNTPs among initially CC-only smokers may result in lower CVD risk compared with continued CC-only use. however, NNTP use on CC cessation was associated with higher CVD risk compared with CC ces sation without NNTPs. Therefore, while NNTPs may have lower CVD risk than CCs, quitters of CCs who use NNTPs may be exposed to higher CVD risk than those who quit CCs without NNTPs. It is important for CC users to be aware of the potential risks and benefits of NNTPs when considering using them as a harm-reduction tool.

Choi S, Lee K, Park SM. Combined associations of Changes in Noncombustible Nicotine or Tobacco Product and Combustible Cigarette Use habits With Subsequent Short-Term Cardiovascular Disease Risk among South Korean Men: a Nationwide Cohort Study. Circulation. 2021;144(19):1528-1538. doi:10.1161/CIRCULaTIONaha.121.054967