Non-cigarette Tobacco Use and Stroke Among West Africans: Evidence From the SIREN Study.
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Fakunle Adekunle Gregory, Okekunle Akinkunmi Paul, Asowata Osahon Jeffery, Akpa Onoja, Sarfo Fred S, Akpalu Albert, Wahab Kolawole, Obiako Reginald, Komolafe Morenikeji, Owolabi Lukman, Osaigbovo Godwin O, Adeoye Abiodun M, Tiwari Hemant K, Uvere Ezinne O, Akinyemi Joshua, Jenkins Carolyn, Arulogun Oyedunni, Ibinaiye Philip, Appiah Lambert T, Bello Temilade, Singh Arti, Yaria Joseph, Calys-Tagoe Benedict, Ogbole Godwin, Chukwuonye Ijezie, Melikam Chidinma, Adebayo Philip, Mensah Yaw, Adebayo Oladimeji, Adeniyi Sunday, Oguike Wisdom, Donna Arnett, Akinyemi Rufus, Ovbiagele Bruce, Owolabi Mayowa
Аннотация
METHODS: A total of 7617 respondents (NCT users: 41 vs. non-NCT: 7576) from the Stroke Investigative Research and Educational Network (SIREN) study were included in the current analysis. NCT use was defined as self-reported use of smoked (cigars or piper) or smokeless (snuff or chewed) tobacco in the past year preceding stroke events. Stroke was defined based on clinical presentation and confirmed with a cranial computed tomography/magnetic resonance imaging. Multivariable-adjusted logistic regression was applied to estimate the odds ratio (OR) and 95% confidence interval (CI) for the relationship of NCT with stroke at a two-sided p < .05.
RESULTS: Out of the 41 (0.54%) who reported NCT use, 27 (65.9%) reported using smokeless NCT. NCT users were older than non-NCT users (62.8 ± 15.7 vs. 57.7 ± 14.8 years). Overall, NCT use was associated with first-ever stroke (OR: 2.08; 95% CI: 1.02, 4.23) in the entire sample. Notably, smokeless NCT use was independently associated with higher odds of stroke (OR: 2.74; 95% CI: 1.15, 6.54), but smoked NCT use (OR: 0.16; 95% CI: 0.02, 1.63) presented a statistically insignificant association after adjusting for hypertension and other covariates.
CONCLUSIONS: NCT use was associated with higher odds of stroke, and public health interventions targeting NCT use might be promising in reducing the burden of stroke among indigenous Africans.
IMPLICATIONS: A detailed understanding of the relationship between NCT use and stroke will likely inform well-articulated policy guidance and evidence-based recommendations for public health prevention and management of stroke on the African continent.