Abstract 18350: Impact of Amount vs Duration of Smoking on Incident Heart Failure and Mortality Among Community-dwelling Older Adults: Need to Reassess the Role of Pack-years as a Tool to Estimate Smoking

Background: Clinicians and public health professionals often use pack-years (PY) to quantify amount and duration of smoking. Thus, 40 PY of smoking may mean 1 pack of cigarette a day for 40 years or 4 packs a day for 10 years. However, it is unknown if the impact of smoking as measured by PY may vary by amount and duration. Methods: Of the 3185 community-dwelling adults ≥65 years without prevalent heart failure (HF) in the Cardiovascular Health Study (CHS), 2556 were never-smokers. The 629 current smokers smoked a median of 1 (20 cigarettes) pack a day (PPD) for a median of 51 years resulting in a median of 42 PYs of smoking. Of 319 smoking ≥1 PPD, 125 smoked u003c51 years (higher-amount-“shorter”-duration; median 49 PY) and of 336 smoking ≥51 years, 142 smoked u003c1 PPD (lower-amount-longer-duration; median 27 PY). Age-sex-race-adjusted hazard ratios (aHR) and 95% CI for centrally-adjudicated incident HF and all-cause mortality during 13 (mean, 10) years of follow-up for the two smoker groups (vs. never smokers...