Review with meta-analysis relating North American,European and Japanese snus or smokeless tobacco use to major smoking-related diseases

作     者：Peter Nicholas Lee Katharine Jane Coombs Janette Susan Hamling 

作者机构：Department of Medical Statistics and EpidemiologyP.N.Lee Statistics and Computing LtdSutton SM25DASurreyUnited Kingdom Department of Medical Statistics and EpidemiologyRoeLee Statistics LtdSutton SM25DASurreyUnited Kingdom 

出 版 物：《World Journal of Meta-Analysis》 (世界荟萃分析杂志)

年 卷 期：2022年第10卷第3期

页      面：130-142页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Smokeless tobacco Moist snuff Lung disease Cardiovascular disease Meta-analysis Review 

摘      要：BACKGROUND While extensive information exists relating cigarette smoking to the risk of lung cancer,chronic obstructive pulmonary disease(COPD),ischaemic heart disease(IHD)or acute myocardial infarction(AMI),and stroke,far less information is available on risks from moist snuff(“snus)or smokeless tobacco(ST)in United States/Canada,Europe or *** To summarize data from the selected countries on risks of the four diseases associated with current ST or snus *** Publications in English in 1990-2020 were considered that,based on epidemiological studies in North America,Europe or Japan,estimated risks of lung cancer,COPD,IHD/AMI,or stroke according to use of ST or *** studies should involve at least 100 cases of the disease considered,and not be restricted to those with specific other *** literature searches were conducted,selecting papers initially from examination of titles and abstracts,and then from full *** papers were sought from reference lists in selected papers,reviews and *** each disease,relative risk estimates adjusted at least for age were extracted relating ST or snus use to risk,and combined using random-effects *** estimates were mainly for current *** or non-current use,but results for ever vs never use were also *** Seven publications reported results for ST use from six United States *** most useful results came from four studies which provided results for current *** ***-effects meta-analyses of these results showed an increased risk for each disease,clearest for lung cancer(relative risk 1.59,95%confidence interval 1.06-2.39,based on 4 estimates)and COPD(1.57,1.09-2.26,n=3),but also significant(at P0.05)for IHD(1.26,1.10-1.45,n=4)and stroke(1.27,1.03-1.57,n=4).Also including results for ever *** use from two other studies increased the lung cancer estimate to 1.80(1.23-2.64,n=6),but had little effect on the other *** snus,16 pu