Background: Cardiovascular disease (CVD) is the leading cause of death globally since the turn of the century. One major risk factor is tobacco smoking with a particular risk associated with early initiation/greater duration. Research also indicates that alcohol use can offer both risk or protective cardiovascular benefits depending on consumption characteristics (intensity, frequency, dose, type). The purpose of this study is to examine the early onset of smoking, heavy smoking, and alcohol behavior as they relate to CVD risk. Methods: Using the data from the 2019 National Survey on Drug Use and Health (N=56,136), logistic regression analysis were conducted to examine trends in heavy substance use predictive of CVD risk (Independent variables of heavy substance use: number of cigarettes smoked per day, ≤ 12 years of tobacco smoking, ≥ 5 drinks for males or ≥ 4 drinks for females on each of 5 or more days in the past 30 days; and the dependent variable - ever told by a doctor or other health care professional that you had heart condition) while controlling for sociodemographic factors. Results: Overall, 19.7% of the study population reported CVD conditions, 5.9% heavy alcohol consumption, and 4.9% early onset of smoking. Overall, the odds of having heart condition among heavy alcohol drinkers was 23.6% less than those who were not heavy alcohol drinkers (odds ratio (OR): 0.76, 95% confidence interval (CI): (0.63-0.92), 44% more among those smoked 26 or more cigarettes per day than 25 or less 1.44 (1.01-2.05), 49% more among those with early onset of smoking than none 1.49 (1.15-1.93). By age, we found that heavy alcohol consumption could be either risk factor or protective factor of heart condition or no effect on heart condition across different age groups: for aged 12-18, OR 1.69 (CI 0.69-4.16); 19-25, 0.75 (0.48-1.15), 26-29, 1.21 (0.57-2.53); 30-34, 0.80 (0.36-1.77); 35-49, 0.61 (0.40-0.93); 50-64, 1.12 (0.77-1.62); >64, 0.93 (0.57-1.52). Based on gender, CVD risk was higher in males than females, 1.22 (1.13-1.32). In terms of race, the odds of CVD risk were lower for all groups when compared with non-Hispanic White. Based on income, the odds of CVD risk were higher in high-income earners with at least a college education when compared to low-income earners with high school education or less (≥$50k vs.Conclusion: Study findings demonstrate that the association of heavy alcohol consumption related to CVD risk varied by age. For heavy tobacco smoking, early onset of tobacco smoking, being male, white race, having above high school level education, high income, and advanced age were found to be significant predictors of CVD risk. Future observational studies should be performed to determine the combined effects of heavy alcohol consumption and heavy smoking as it relates to CVD risk by other behavioral risk factors such as types of alcohol consumed (i.e, spirits vs wine) and related behaviors.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22036号 / 医博第4521号 / 新制||医||1038(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 滝田 順子, 教授 松田 道行, 教授 山田 亮 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM