While the effect of cigarette smoking on coronary heart disease is well known, its effect on atrial fibrillation (AF) is unclear.
The U.S. Atherosclerosis Risk in Communities (ARIC) Study offered the opportunity to examine whether smoking increases the risk of incident AF in a cohort of over 15,000 participants with a mean follow-up time of 13.1 years.
Compared to never smokers, current smoking at baseline was associated with a more than two-fold risk of incident AF. Former smokers had lower risk compared to current smokers, indicating that the accumulated dose of smoking was important. 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.