Patterns of tobacco use among smokers prior to hospitalization for an acute cardiac event: Use of combusted and non-combusted products

Irene Pericot-Valverde, Rebecca J. Elliott, Jeff S. Priest, Trace Barret, Jin H. Yoon, Charles C. Miller, Chizimuzo T.C. Okoli, Ilana Haliwa, Philip A. Ades, Diann E. Gaalema

Research output: Contribution to journalArticlepeer-review

5 Scopus citations


Use of tobacco products before or after a cardiac event increases risk of morbidity and mortality. Unlike cigarette smoking, which is generally screened in the healthcare system, identifying the use of other tobacco products remains virtually unexplored. This study aimed at characterizing the use of other non-combusted tobacco products in addition to combusted products among cardiac patients and identifying a profile of patients who are more likely to use non-combusted products. Patients (N = 168) hospitalized for a coronary event who reported being current cigarette smokers completed a survey querying sociodemographics, cardiac diagnoses, use of other tobacco products, and perceptions towards these products. Classification and regression tree (CART) analysis was used to identify which interrelationships of participants characteristics led to profiles of smoking cardiac patients more likely to also be using non-combusted tobacco products. Results showed that non-combusted tobacco product use ranged from 0% to 47% depending on patient characteristic combinations. Younger age and lower perception that cigarette smoking is responsible for their cardiac condition were the strongest predictive factors for use of non-combusted products. Tobacco product use among cardiac patients extends beyond combusted products (13.7% non-combusted product use), and consequently, screening in health care settings should be expanded to encompass other tobacco product use. This study also characterizes patients likely to be using non-combusted products in addition to combusted, a group at high-risk due to their multiple product use, but also a group that may be amenable to harm reduction approaches and evidence-based tobacco treatment strategies.

Original languageEnglish
Article number105757
JournalPreventive Medicine
StatePublished - Nov 2019

Bibliographical note

Funding Information:
Research reported in this publication was supported by the National Heart, Lung, And Blood Institute (NHLBI) of the National Institutes of Health under Award Number R61HL143305 , Center of Biomedical Research Excellence award P20GM103644 from the National Institute of General Medical Sciences (NIGMS), and National Institute of Drug Abuse ( NIDA )/FDA grant U54DA031659 . The content is solely the responsibility of the authors and does not necessarily represent the official views of NHLBI, NIDA, NIGMS, or the FDA.

Publisher Copyright:
© 2019 Elsevier Inc.


  • Cardiac patients
  • Combusted tobacco products
  • Dual use
  • Non-combusted tobacco products
  • Tobacco

ASJC Scopus subject areas

  • Epidemiology
  • Public Health, Environmental and Occupational Health


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