Table 4. Open in new tab Discrete time...

	Myocardial infarction	Stroke
Time-varying cigarettes/ENDS use
Non-current use	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Exclusive cigarette use	1.63^**	1.23–2.16	1.99^***	1.40–2.84	2.37^***	1.76–3.19	2.26^***	1.51–3.39
Exclusive ENDS use	0.59	0.12–2.62	0.61	0.12–3.04	1.45	0.48–4.36	1.74	0.55–5.49
Dual use	1.12	0.41–3.09	1.84	0.64–5.30	0.94	0.28–3.14	1.12	0.33–3.79
Sociodemographic factors
Age	1.05^***	1.04–1.06	1.04^***	1.03–1.06	1.04^***	1.03–1.06	1.04^***	1.03–1.06
Sex
Female	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Male	1.53^*	1.07–2.20	1.71^**	1.18–2.46	1.14	0.85–1.53	1.21	0.89–1.64
Race/ethnicity
NH White	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Hispanic	0.76	0.45–1.26	0.84	0.50–1.42	0.64	0.34–1.22	0.65	0.35–1.23
NH Black	1.10	0.71–1.69	0.94	0.60–1.48	1.57^*	1.10–2.25	1.29	0.92–1.82
Another race/ethnicity	0.39^*	0.19–0.82	0.52	0.25–1.10	0.75	0.42–1.30	0.98	0.59–1.63
Education
High school or less	3.60^***	1.99–6.54	2.89^**	1.56–5.36	3.98^***	1.79–8.85	2.79^*	1.24–6.26
Some college/associates degree	2.04^*	1.08–3.86	1.86	0.98–3.56	2.41^***	1.10–5.32	1.96	0.87–4.43
Bachelor degree	0.99	0.45–2.20	1.10	0.49–2.44	1.16	0.43–3.08	1.24	0.46–3.35
Graduate degree	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Smoking history at baseline
Former established smoking	1.60^*	1.09–2.35	1.43	0.91–2.24	0.80	0.47–1.38	0.70	0.39–1.25
Cigarette pack-years^a	1.13^***	1.08–1.17	0.98	0.92–1.04	1.12^**	1.04–1.19	1.02	0.93–1.11
Baseline risk factors
Family history of premature MI^b	2.85^***	2.00–4.04	2.68^***	1.84–3.90	2.50^***	1.74–3.60	2.25^***	1.59–3.18
Hypertension diagnosis	2.52^***	1.79–3.54	1.56^*	1.01–2.40	2.21^***	1.64–2.99	1.29	0.90–1.86
Diabetes diagnosis	2.22^***	1.55–3.19	1.45	0.95–2.25	2.58^***	1.77–3.74	1.85^**	1.21–2.82

Myocardial infarction

Stroke

Unadjusted

Adjusted

Unadjusted

Adjusted

Hazard

95% CI

Hazard

95% CI

Hazard

95% CI

Hazard

95% CI

Time-varying cigarettes/ENDS use

Non-current use

Ref

Exclusive cigarette use

1.63^**

1.23–2.16

1.99^***

1.40–2.84

2.37^***

1.76–3.19

2.26^***

1.51–3.39

Exclusive ENDS use

0.59

0.12–2.62

0.61

0.12–3.04

1.45

0.48–4.36

1.74

0.55–5.49

Dual use

1.12

0.41–3.09

1.84

0.64–5.30

0.94

0.28–3.14

1.12

0.33–3.79

Sociodemographic factors

Age

1.05^***

1.04–1.06

1.04^***

1.03–1.06

1.04^***

1.03–1.06

1.04^***

1.03–1.06

Sex

Female

Ref

Male

1.53^*

1.07–2.20

1.71^**

1.18–2.46

1.14

0.85–1.53

1.21

0.89–1.64

Race/ethnicity

NH White

Ref

Hispanic

0.76

0.45–1.26

0.84

0.50–1.42

0.64

0.34–1.22

0.65

0.35–1.23

NH Black

1.10

0.71–1.69

0.94

0.60–1.48

1.57^*

1.10–2.25

1.29

0.92–1.82

Another race/ethnicity

0.39^*

0.19–0.82

0.52

0.25–1.10

0.75

0.42–1.30

0.98

0.59–1.63

Education

High school or less

3.60^***

1.99–6.54

2.89^**

1.56–5.36

3.98^***

1.79–8.85

2.79^*

1.24–6.26

Some college/associates degree

2.04^*

1.08–3.86

1.86

0.98–3.56

2.41^***

1.10–5.32

1.96

0.87–4.43

Bachelor degree

0.99

0.45–2.20

1.10

0.49–2.44

1.16

0.43–3.08

1.24

0.46–3.35

Graduate degree

Ref

Smoking history at baseline

Former established smoking

1.60^*

1.09–2.35

1.43

0.91–2.24

0.80

0.47–1.38

0.70

0.39–1.25

Cigarette pack-years^a

1.13^***

1.08–1.17

0.98

0.92–1.04

1.12^**

1.04–1.19

1.02

0.93–1.11

Baseline risk factors

Family history of premature MI^b

2.85^***

2.00–4.04

2.68^***

1.84–3.90

2.50^***

1.74–3.60

2.25^***

1.59–3.18

Hypertension diagnosis

2.52^***

1.79–3.54

1.56^*

1.01–2.40

2.21^***

1.64–2.99

1.29

0.90–1.86

Diabetes diagnosis

2.22^***

1.55–3.19

1.45

0.95–2.25

2.58^***

1.77–3.74

1.85^**

1.21–2.82

	Myocardial infarction	Stroke
Time-varying cigarettes/ENDS use
Non-current use	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Exclusive cigarette use	1.63^**	1.23–2.16	1.99^***	1.40–2.84	2.37^***	1.76–3.19	2.26^***	1.51–3.39
Exclusive ENDS use	0.59	0.12–2.62	0.61	0.12–3.04	1.45	0.48–4.36	1.74	0.55–5.49
Dual use	1.12	0.41–3.09	1.84	0.64–5.30	0.94	0.28–3.14	1.12	0.33–3.79
Sociodemographic factors
Age	1.05^***	1.04–1.06	1.04^***	1.03–1.06	1.04^***	1.03–1.06	1.04^***	1.03–1.06
Sex
Female	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Male	1.53^*	1.07–2.20	1.71^**	1.18–2.46	1.14	0.85–1.53	1.21	0.89–1.64
Race/ethnicity
NH White	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Hispanic	0.76	0.45–1.26	0.84	0.50–1.42	0.64	0.34–1.22	0.65	0.35–1.23
NH Black	1.10	0.71–1.69	0.94	0.60–1.48	1.57^*	1.10–2.25	1.29	0.92–1.82
Another race/ethnicity	0.39^*	0.19–0.82	0.52	0.25–1.10	0.75	0.42–1.30	0.98	0.59–1.63
Education
High school or less	3.60^***	1.99–6.54	2.89^**	1.56–5.36	3.98^***	1.79–8.85	2.79^*	1.24–6.26
Some college/associates degree	2.04^*	1.08–3.86	1.86	0.98–3.56	2.41^***	1.10–5.32	1.96	0.87–4.43
Bachelor degree	0.99	0.45–2.20	1.10	0.49–2.44	1.16	0.43–3.08	1.24	0.46–3.35
Graduate degree	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Smoking history at baseline
Former established smoking	1.60^*	1.09–2.35	1.43	0.91–2.24	0.80	0.47–1.38	0.70	0.39–1.25
Cigarette pack-years^a	1.13^***	1.08–1.17	0.98	0.92–1.04	1.12^**	1.04–1.19	1.02	0.93–1.11
Baseline risk factors
Family history of premature MI^b	2.85^***	2.00–4.04	2.68^***	1.84–3.90	2.50^***	1.74–3.60	2.25^***	1.59–3.18
Hypertension diagnosis	2.52^***	1.79–3.54	1.56^*	1.01–2.40	2.21^***	1.64–2.99	1.29	0.90–1.86
Diabetes diagnosis	2.22^***	1.55–3.19	1.45	0.95–2.25	2.58^***	1.77–3.74	1.85^**	1.21–2.82

Table 4.

Open in new tab

Discrete time survival analysis predicting incident myocardial infarction/stroke, Population Assessment of Tobacco, and Health (Waves 1–5, 2013–2019)

	Myocardial infarction				Stroke
	Unadjusted		Adjusted		Unadjusted		Adjusted
	Hazard	95% CI	Hazard	95% CI	Hazard	95% CI	Hazard	95% CI
Time-varying cigarettes/ENDS use
Non-current use	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Exclusive cigarette use	1.63^**	1.23–2.16	1.99^***	1.40–2.84	2.37^***	1.76–3.19	2.26^***	1.51–3.39
Exclusive ENDS use	0.59	0.12–2.62	0.61	0.12–3.04	1.45	0.48–4.36	1.74	0.55–5.49
Dual use	1.12	0.41–3.09	1.84	0.64–5.30	0.94	0.28–3.14	1.12	0.33–3.79
Sociodemographic factors
Age	1.05^***	1.04–1.06	1.04^***	1.03–1.06	1.04^***	1.03–1.06	1.04^***	1.03–1.06
Sex
Female	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Male	1.53^*	1.07–2.20	1.71^**	1.18–2.46	1.14	0.85–1.53	1.21	0.89–1.64
Race/ethnicity
NH White	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Hispanic	0.76	0.45–1.26	0.84	0.50–1.42	0.64	0.34–1.22	0.65	0.35–1.23
NH Black	1.10	0.71–1.69	0.94	0.60–1.48	1.57^*	1.10–2.25	1.29	0.92–1.82
Another race/ethnicity	0.39^*	0.19–0.82	0.52	0.25–1.10	0.75	0.42–1.30	0.98	0.59–1.63
Education
High school or less	3.60^***	1.99–6.54	2.89^**	1.56–5.36	3.98^***	1.79–8.85	2.79^*	1.24–6.26
Some college/associates degree	2.04^*	1.08–3.86	1.86	0.98–3.56	2.41^***	1.10–5.32	1.96	0.87–4.43
Bachelor degree	0.99	0.45–2.20	1.10	0.49–2.44	1.16	0.43–3.08	1.24	0.46–3.35
Graduate degree	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Smoking history at baseline
Former established smoking	1.60^*	1.09–2.35	1.43	0.91–2.24	0.80	0.47–1.38	0.70	0.39–1.25
Cigarette pack-years^a	1.13^***	1.08–1.17	0.98	0.92–1.04	1.12^**	1.04–1.19	1.02	0.93–1.11
Baseline risk factors
Family history of premature MI^b	2.85^***	2.00–4.04	2.68^***	1.84–3.90	2.50^***	1.74–3.60	2.25^***	1.59–3.18
Hypertension diagnosis	2.52^***	1.79–3.54	1.56^*	1.01–2.40	2.21^***	1.64–2.99	1.29	0.90–1.86
Diabetes diagnosis	2.22^***	1.55–3.19	1.45	0.95–2.25	2.58^***	1.77–3.74	1.85^**	1.21–2.82

	Myocardial infarction				Stroke
	Unadjusted		Adjusted		Unadjusted		Adjusted
	Hazard	95% CI	Hazard	95% CI	Hazard	95% CI	Hazard	95% CI
Time-varying cigarettes/ENDS use
Non-current use	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Exclusive cigarette use	1.63^**	1.23–2.16	1.99^***	1.40–2.84	2.37^***	1.76–3.19	2.26^***	1.51–3.39
Exclusive ENDS use	0.59	0.12–2.62	0.61	0.12–3.04	1.45	0.48–4.36	1.74	0.55–5.49
Dual use	1.12	0.41–3.09	1.84	0.64–5.30	0.94	0.28–3.14	1.12	0.33–3.79
Sociodemographic factors
Age	1.05^***	1.04–1.06	1.04^***	1.03–1.06	1.04^***	1.03–1.06	1.04^***	1.03–1.06
Sex
Female	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Male	1.53^*	1.07–2.20	1.71^**	1.18–2.46	1.14	0.85–1.53	1.21	0.89–1.64
Race/ethnicity
NH White	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Hispanic	0.76	0.45–1.26	0.84	0.50–1.42	0.64	0.34–1.22	0.65	0.35–1.23
NH Black	1.10	0.71–1.69	0.94	0.60–1.48	1.57^*	1.10–2.25	1.29	0.92–1.82
Another race/ethnicity	0.39^*	0.19–0.82	0.52	0.25–1.10	0.75	0.42–1.30	0.98	0.59–1.63
Education
High school or less	3.60^***	1.99–6.54	2.89^**	1.56–5.36	3.98^***	1.79–8.85	2.79^*	1.24–6.26
Some college/associates degree	2.04^*	1.08–3.86	1.86	0.98–3.56	2.41^***	1.10–5.32	1.96	0.87–4.43
Bachelor degree	0.99	0.45–2.20	1.10	0.49–2.44	1.16	0.43–3.08	1.24	0.46–3.35
Graduate degree	Ref	Ref	Ref	Ref	Ref	Ref	Ref	Ref
Smoking history at baseline
Former established smoking	1.60^*	1.09–2.35	1.43	0.91–2.24	0.80	0.47–1.38	0.70	0.39–1.25
Cigarette pack-years^a	1.13^***	1.08–1.17	0.98	0.92–1.04	1.12^**	1.04–1.19	1.02	0.93–1.11
Baseline risk factors
Family history of premature MI^b	2.85^***	2.00–4.04	2.68^***	1.84–3.90	2.50^***	1.74–3.60	2.25^***	1.59–3.18
Hypertension diagnosis	2.52^***	1.79–3.54	1.56^*	1.01–2.40	2.21^***	1.64–2.99	1.29	0.90–1.86
Diabetes diagnosis	2.22^***	1.55–3.19	1.45	0.95–2.25	2.58^***	1.77–3.74	1.85^**	1.21–2.82

Myocardial infarction persons n = 11 031, person-years = 38 700; Stroke persons n = 11 076, person-years n = 38,808.

ENDS = electronic nicotine delivery systems; MI = myocardial infarction.

p < .05.

p < .01.

p < .001.

Rescaled to 10 pack-year intervals for models.

Prior to age 50.

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