TY - JOUR
T1 - Non-cigarette Tobacco Use and Stroke Among West Africans
T2 - Evidence From the SIREN Study
AU - Gregory Fakunle, Adekunle
AU - Paul Okekunle, Akinkunmi
AU - Jeffery Asowata, Osahon
AU - Akpa, Onoja
AU - Sarfo, Fred S.
AU - Akpalu, Albert
AU - Wahab, Kolawole
AU - Obiako, Reginald
AU - Komolafe, Morenikeji
AU - Owolabi, Lukman
AU - Osaigbovo, Godwin O.
AU - Adeoye, Abiodun M.
AU - Tiwari, Hemant K.
AU - Uvere, Ezinne O.
AU - Akinyemi, Joshua
AU - Jenkins, Carolyn
AU - Arulogun, Oyedunni
AU - Ibinaiye, Philip
AU - Appiah, Lambert T.
AU - Bello, Temilade
AU - Singh, Arti
AU - Yaria, Joseph
AU - Calys-Tagoe, Benedict
AU - Ogbole, Godwin
AU - Chukwuonye, Ijezie
AU - Melikam, Chidinma
AU - Adebayo, Philip
AU - Mensah, Yaw
AU - Adebayo, Oladimeji
AU - Adeniyi, Sunday
AU - Oguike, Wisdom
AU - Donna, Arnett
AU - Akinyemi, Rufus
AU - Ovbiagele, Bruce
AU - Owolabi, Mayowa
N1 - Publisher Copyright:
© The Author(s) 2023.
PY - 2024/5/1
Y1 - 2024/5/1
N2 - Introduction: Non-cigarette tobacco (NCT) represents a form of tobacco use with a misperceived significance in chronic disease events. Whether NCT use is sufficient to promote stroke events, especially among Africans, is yet to be understood. This study assessed the relationship between NCT use and stroke among indigenous Africans. 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.
AB - Introduction: Non-cigarette tobacco (NCT) represents a form of tobacco use with a misperceived significance in chronic disease events. Whether NCT use is sufficient to promote stroke events, especially among Africans, is yet to be understood. This study assessed the relationship between NCT use and stroke among indigenous Africans. 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.
UR - http://www.scopus.com/inward/record.url?scp=85191105287&partnerID=8YFLogxK
U2 - 10.1093/ntr/ntad239
DO - 10.1093/ntr/ntad239
M3 - Article
C2 - 38015428
AN - SCOPUS:85191105287
SN - 1462-2203
VL - 26
SP - 589
EP - 596
JO - Nicotine and Tobacco Research
JF - Nicotine and Tobacco Research
IS - 5
ER -
