Smoking and incidence of atrial fibrillation: results from the Atherosclerosis Risk in Communities (ARIC) study
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Background Cigarette smoking increases the risk of coronary heart disease, but whether smoking increases atrial fibrillation (AF) is uncertain.Objective The purpose of this study was to determine the association of cigarette smoking with incident AF in a population-based cohort of blacks and whites.Methods We determined the risk of incident AF through December 2002 in relation to baseline (1987-1989) smoking status and cigarette-years of smoking in over 15,000 participants of the prospective Atherosclerosis Risk in Communities (ARIC) study.Results Over a mean follow-up of 13.1 years, 876 incident AF events were identified. Compared to never smokers, the multivariable-adjusted hazard ratios (HRs) for AF were 1.32 (95% confidence interval [CI] 1.10-1.57) in former smokers, 2.05 (95% CI 1.71-2.47) in current smokers, and 1.58 (95% CI 1.35-1.85) in ever smokers. In the highest tertile of accumulated smoking amount (>675 cigarette-years), the incidence of AF was 2.10 times greater (95% CI 1.74-2.53) than in those who never smoked. Associations were similar by gender, race, type of event (AF and atrial flutter), and when only AF events identified by study exam ECGs were included. Finally, individuals who quit smoking exhibited a trend indicating a slightly lower risk of developing AF (HR 0.88, 95% CI 0.65-1.17) compared to those who continued to smoke.Conclusion Smoking was associated with the incidence of AF, with more than a two-fold increased risk of AF attributed to current smoking. In addition, a trend toward a lower incidence of AF appeared among smokers who quit compared to continued smokers.
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Smoking is independently associated with AF, with former smoking HR 1.32 and current smoking HR 2.05 compared with never smoking.
“Smoking 212 never former current HR: 1.00 (reference) 1.32 (95% CI 1.10-1.57)2.05 (95% CI 1.71-2.47)”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [212]
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- Authors
- Chamberlain, A. M., Agarwal, S. K., Folsom, A. R., Duval, S., Soliman, E. Z., Ambrose, M., Eberly, L. E., & Alonso, A.
- Affiliations
- Mayo Clinic (US)
- University of North Carolina at Chapel Hill (US)
- University of Minnesota (US)
- Wake Forest University Health Sciences (US)
- Johns Hopkins University (US)
- Corresponding author
- Chamberlain, Alanna M.
- ORCID
- Venue
- Heart Rhythm
- Publisher
- Elsevier BV
- Published
- 2011-08
- Volume
- 8
- Issue
- 8
- Pages
- 1160-1166
- ISSN
- 1547-5271 (ISSN-L)
- PMC
- PMC3139831
- OpenAlex
- W2088355697
- Cited by
- 284
- References
- 32
- Citations by year
- 2026: 17 · 2025: 23 · 2024: 33 · 2023: 27 · 2022: 28 · 2021: 27 · 2020: 26 · 2019: 16 · 2018: 14 · 2017: 19 · 2016: 16 · 2015: 12 · 2014: 15 · 2013: 6 · 2012: 3
- FWCI
- 5.48
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Heart Rhythm (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- American Heart Association
- National Institutes of Health (5rc1hl099452-02, n01hc55021-47-0-1, n01hc55020-39-0-0, n01hc55016-37-0-0, n01hc055022-024, n01hc55019-35-0-1, n01hc55018-38-0-1, n01hc55015-48-0-1)
- National Heart, Lung, and Blood Institute (N01-HC55022, N01 HC055016, N01-HC-55018, N01 HC 55020, N01 HC 55019, N01 HC055020, N01 HC055018, N01-HC55016, N01 HC055022, N01 HC055019, N01‐HC‐55015, N01-HC55021, N01 HC055021, N01 HC055015, T32HL007779, RC1-HL099452)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Health Sciences › Medicine › Epidemiology › Acute Ischemic Stroke Management
- Keywords
- cigarette smoking, atrial fibrillation, atrial flutter, smoking cessation, smoking intensity, incident atrial fibrillation, cardiovascular risk factors, Atherosclerosis Risk in Communities Study
- MeSH terms
- Atrial Fibrillation, Female, Humans, Male, Middle Aged, Smoking, Cohort Studies, Incidence, Proportional Hazards Models, Risk Assessment
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