The heart-breaking news about tobacco: it's all bad.

摘要

During the present century, about 1 billion people will die of smoking-related conditions if current trends persist; a substantial proportion due to cardiovascular disease. In today's Lancet, Koon Teo and colleagues2 provide a wealth of new data documenting the causal link between smoking and acute myocardial infarction in over 12000 cases from around the world. Their INTERHEART study used a standardised protocol to select cases and controls, and gather uniform information from 262 sites in 52 countries. The study represents a model for international cooperation, and shows the unique global coverage that permitted investigators to assess a wide range of patterns of tobacco use. The large sample sheds new light on many specific subgroups on the basis of region, age, sex, and form of exposure. The overwhelming conclusion from this mass of data is that tobacco exposure-be it cigarettes, pipes, cigars, beedies, sheesha, or smokeless; second-hand or primary; filtered or non-filtered, even at low levels-causes a large proportion of myocardial infarcts in men and women around the world.