Abstract
Cigarette smoking is one of the most important causes of chronic diseases and immature deaths
globally which has led to numerous epidemiological studies conducted to identify the association between
smoking and various types of diseases. The objectives of this study are systematically review existing
epidemiological literature on cardiovascular risk from smoking and to synthesize a pooled relative
risks based on meta-analysis of those literature. Review protocol has been developed to identify relevant
and comprehensive keywords and to ensure appropriate inclusion/exclusion criteria are applied without
bias.
Between 1994- 2011, 881 and 272 papers have been identified from the literature search for ischaemic
heart diseases (IHD) and cerebrovascular diseases (CVD) respectively. This was later reduced to 14 for
IHD and 20 for CVD. When meta- analysis was performed, it was found that the relative risk of developing
IHD from smoking was 2.14 (1.76-2.60) for men and 2.84 (1.90-4.24) for women, while for CVD, it was
1.66 (1.43-1.93) for men and 2.18 (1.67-2.85) for women. For sub-group analysis, it was found that for Asian
population, the relative risk of developing IHD was 2.15 (1.69-2.75) for men and 1.99 (1.18-3.34) for women,
and for CVD, it was 1.31 (1.19-1.44) for men and 1.60 (1.25-2.04) for women.
This study has confirmed the harm from smoking and the association between smoking and cardiovascular
morbidity. The fact that relative risk in Asian population is relatively lower compared to the rest
of the World does not imply that there is less harm from cigarette smoking in this population but may
occur as a result of significant presence of other risk factors, such as quality and access to medical treatment
for hypertension and dyslipidaemia, within the population.
