Erik Swain , 2025-05-07 13:13:00
Key takeaways:
- Tobacco-related ischemic heart disease mortality has increased in the U.S. since 1999.
- The aging of the population and the introduction of novel nicotine products may be among the drivers.
Tobacco-related ischemic heart disease mortality has risen in the U.S. since 1999, but the impact has varied by race and by geographic region, according to data from the CDC WONDER database.
For an analysis presented at the Society for Cardiovascular Angiography and Interventions Scientific Sessions, the researchers assessed age-adjusted mortality rates for Americans aged 25 years or older with ischemic heart disease attributable to tobacco use using death certificate data from CDC WONDER.
“We all know that tobacco use has been linked to coronary heart disease and cardiovascular disease, but there is a lack of nationally representative data,” Roopeessh Vempati, MD, internal medicine resident at Trinity Health Oakland Hospital in Pontiac, Michigan, and Wayne State University in Detroit, told Healio.
Deaths from ischemic heart disease attributable to tobacco use increased from 4,669 in 1999 to 56,367 in 2020, and an autoregressive integrated moving average model projects a rise to 80,985 in 2030, which would be a 43.7% increase from 2020, according to the researchers.
“This is very alarming, and a preventable crisis,” Vempati told Healio.
Age-adjusted mortality rates rose over time in all age groups, Vempati and colleagues found.
For men, the annual percentage change in age-adjusted mortality rates was 40.39 between 1999 and 2005, and it rose more slowly after that, for an average annual percentage change of 11.93 for the entire study period, they found.
Among men, the highest average annual percentage changes in age-adjusted mortality rates were in white individuals (12.01%) and Native American/Alaska Native individuals (10.46%), according to the researchers.
For women, the annual percentage change in age-adjusted mortality rates also rose over time, but at a slower rate than men, Vempati and colleagues found.
Average annual percentage change in age-adjusted mortality rates was 10.39% in Black women, 9.76% in Native American/Alaska Native women and 11.46% in Asian American and Pacific Islander women, the researchers found.
Black individuals had a very high annual percentage change in age-adjusted mortality rates between 2001 and 2005 (46.98%), which was lower thereafter and was 10.85% for the entire study period, according to the researchers.
Changes in age-adjusted mortality rates varied greatly by state and were highest in Vermont (40.2) and North Dakota (38.3) and were lowest in California (2.3) and Massachusetts (4.9), according to the researchers.
“There are various trends that may be contributing to mortality from tobacco use,” Vempati told Healio. “First and foremost, the population is aging, and the cumulative exposure from tobacco might ultimately be leading to mortality. A second important factor is the emergence of novel nicotine products … which might be contributing to increased mortality, especially in the younger adults. Another factor is disparities in cessation access programs, and socioeconomic disparities.”
In addition, he said, the data include 2020, the first year of the COVID-19 pandemic, which contributed to a spike in CV mortality.
To reverse the trends, “we have to have a health equity-based approach to address socioeconomic disparities, especially among racial minorities,” Vempati told Healio. “We have to strongly regulate the emerging nicotine products and have a robust public education campaign.”
For more information:
Roopeessh Vempati, MD, can be reached at roopeessh.vempati@gmail.com.
Sources/Disclosures
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Vempati R, et al. Abstract D-46. Presented at: Society for Cardiovascular Angiography and Interventions Scientific Sessions; May 1-3, 2025; Washington, D.C.
Disclosures:
Vempati reports no relevant financial disclosures.
