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Smoking cessation and carotid atherosclerosis: the Guangzhou Biobank Cohort Study—CVD
  1. C Q Jiang1,
  2. L Xu1,2,
  3. T H Lam2,
  4. J M Lin1,
  5. K K Cheng3,
  6. G N Thomas3
  1. 1Molecular Epidemiology Research Centre, Guangzhou Number 12 Hospital, Guangzhou, China
  2. 2Department of Community Medicine, School of Public Health, University of Hong Kong, Hong Kong SAR, China
  3. 3Department of Public Health and Epidemiology, University of Birmingham, Birmingham, UK
  1. Correspondence to Professor Tai Hing Lam, Department of Community Medicine, School of Public Health, The University of Hong Kong, Hong Kong, China; hrmrlth{at}


Introduction Smoking has been shown to be associated with carotid atherosclerosis in cross-sectional and prospective studies in Western populations. However, few studies have examined the reversal of risk resulting from quitting smoking, and the results are conflicting.

Methods 959 men aged 50–85 years were randomly selected from phase III (2006–2007) of the Guangzhou Biobank Cohort Study into this cross-sectional study. Common carotid artery intima-media thickness (CCA-IMT) was measured by B-mode ultrasonography, and carotid artery plaques were identified. Major cardiovascular risk factors, including fasting triglyceride, low-density and high-density lipoprotein (LDL and HDL) cholesterol and glucose, and systolic and diastolic blood pressure, were assessed.

Results CCA-IMT and the number of carotid plaque increased from never to former to current smokers (both p≤0.001). Among former smokers compared to current smokers, after adjustment for cigarette pack-years and other potential confounders, the adjusted ORs (95% CI) for quitting for 1–9, 10–19 and 20+ years were 0.77 (0.47 to 1.26), 0.45 (0.26 to 0.79) and 0.37 (0.17 to 0.77) for the presence of CCA atherosclerosis, and 0.69 (0.43 to 1.12), 0.47 (0.27 to 0.82) and 0.45 (0.23 to 0.96) for the presence of carotid plaques, respectively. Longer duration of quitting smoking was also significantly associated with decreasing risk of the severity of CCA atherosclerosis and carotid plaques (all p≤0.001).

Conclusion Smoking cessation was beneficial in attenuating the risk of carotid atherosclerosis associated with cigarette smoking. The short duration of cessation in earlier studies is a likely explanation for the inconsistent results.

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  • Funding The study is funded by an NSFC/RGC (No 30518001; HKU720/05) grant; The University of Hong Kong Foundation for Educational Development and Research, Hong Kong; the Guangzhou Public Health Bureau and the Guangzhou Science and Technology Bureau, Guangzhou, China; and University of Birmingham, UK.

  • Competing interests None.

  • Patient consent Obtained.

  • Ethics approval The Guangzhou Medical Ethics Committee of the Chinese Medical Association approved the study, and all participants gave written, informed consent before participation.

  • Provenance and peer review Not commissioned; externally peer reviewed.