Stroke and the use of Smokeless tobacco- A case-control study

Background: Smokeless tobacco consumption has a high prevalence and acceptance in the Indian community. Although a lot of studies have been done on the ill effects of smoking, there is a dearth in the literature on the cardiovascular effects of smokeless tobacco. Objectives: This study aimed to see the association between smokeless tobacco and Stroke. Methods: In a retrospective case control study, information on tobacco habits was collected by the means of an interview schedule. 80 case (adult males who had stroke) and 80 controls (adult males who did not have stroke) were identified from four different hospitals in city of Pune in Maharashtra, India. Each case was matched with one control. Results: The unadjusted Odds ratio for any form of tobacco were significant [2.98(1.43-6.19)] but were statistically insignificant for smoking [2.08(0.96-4.47)] and smokeless tobacco [1.50(0.80-2.79)]. The adjusted odds ratio was calculated by using a multinomial logistic regression. After adjusting for the known confounding factors of hypertension, alcohol use and diabetes, the Odds ratio was significant for smokeless tobacco at [2.3 (1.1 – 5.1)] and smoking at[3.6 (1.4 – 9.2)]. Conclusions: The results show that consumption of smokeless tobacco and Stroke are associated. There was also a significant relation between consumption of smokeless tobacco and ischemic stroke.