Smoking in Relation to Atherosclerosis of the Coronary Arteries

Our plain-English summary of Smoking in Relation to Atherosclerosis of the Coronary Arteries, by O. Auerbach, E.C. Hammond, L. Garfinkel (1965).

The study

• Authors: O. Auerbach, E.C. Hammond, L. Garfinkel
• Published: The New England Journal of Medicine, Volume 273 No15. October 7th 1965
• Type of article: Journal article
• Our copy: from Johns-Manville's own medical library. The article is still under copyright, so we describe it here rather than post it.

In plain English

This article does not concern asbestos. It is an autopsy study of cigarette smoking and hardening of the heart's arteries (coronary atherosclerosis). Between 1955 and 1960, 2761 men died at the Veterans Administration Hospital in East Orange, New Jersey, and 1972 were autopsied. Interviewers who did not know the autopsy findings collected past smoking habits from the families of 1509 of these men. The analysis covered 1372 men who died of causes other than coronary heart disease. A pathologist graded each man's coronary arteries as having no, slight, moderate or advanced atherosclerosis, without knowing his smoking habits. After adjusting for age, advanced atherosclerosis was found in 15.3 per cent of men who never smoked regularly and in 45.9 per cent of men who smoked 40 or more cigarettes a day. In every age group, the share of cigarette smokers with advanced disease rose with the number of cigarettes smoked. A comparison of men matched for age and cause of death showed the same pattern. The authors noted that some percentages were statistically unstable because the groups were small.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Autopsy study of men who died in one hospital, with smoking histories collected from their families after death, plus a matched-set analysis
• Who was studied: 1372 men who died at the Veterans Administration Hospital, East Orange, New Jersey, between January 1, 1955, and December 31, 1960, from causes other than coronary heart disease. 126 had never smoked regularly, 893 were current cigarette smokers and 353 were former, pipe or cigar smokers.
• Exposure: Cigarette smoking (never regularly; current smokers of less than 20, 20 to 39, or 40 or more cigarettes a day), and also pipe, cigar and former smoking. No asbestos exposure was studied.
• Main results:
  • After adjusting for age, advanced coronary atherosclerosis was found in 15.3 per cent of men who never smoked regularly and in 45.9 per cent of men who had smoked 40 or more cigarettes a day up to their terminal illness.
  • Within each age group, the proportion of cigarette smokers with advanced atherosclerosis rose consistently with the amount smoked.
  • After adjusting for smoking habits, advanced coronary atherosclerosis rose with age, from 7.5 per cent in men under 45 to 55.0 per cent in men aged 70 or older.
  • In sets of men matched for age and cause of death, advanced atherosclerosis was less common among nonsmokers than among current cigarette smokers and increased with the amount smoked.
  • Taking age into account, current pipe and cigar smokers had about the same (or perhaps slightly greater) degree of atherosclerosis as men who never smoked regularly, and definitely less than current cigarette smokers.
  • Former cigarette smokers had more coronary atherosclerosis than men who never smoked regularly, but somewhat less than current cigarette smokers.
• Limitations the authors state:
  • Because some groups were small, some percentages in Table 2 were statistically unstable.
  • Combining several features into a single grade of atherosclerosis was a matter of judgment.

Topics

Medical terms in this study, explained in our Lexicon: Autopsy, Habit.

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