NSAID increase risk of heart attacks in smokers
Smokers may want to take nonsteroidal anti-inflammatory drugs (NSAID) such as aspirin or ibuprofen as well, according to research reported the Annual Meeting of the American Association for Cancer Research. “The use of NSAIDs among smokers protected against oral cancer development,” said Dr. Jon Sudbø, a cancer researcher from the Norwegian Radium Hospital, Oslo, Norway, and lead author on the study.
People who took NSAIDs over extended periods of time and were light to moderate tobacco smokers had 65 percent less risk of developing oral cancer than smokers who went without NSAIDs, according to a population-based study on patients from the Norwegian Institute of Public Health and the Norwegian Cancer Registry. But at the same time, they had twice the risk of dying of a heart attack, stroke or other heart-related problem. This is in line with the results seen with arthritis patients who had higher risk of heart attacks from Cox-2 drugs (Vioxx, Celebrex, Bextra, Arocoxia, Mobic, etc.). This was the reason for recall of Vioxx and Bextra and a black box warning on Celebrex.
“The results of a significant reduction in oral cancer risk – particularly in light to moderate active smokers – suggest that NSAID use may provide anti-carcinogenetic effect while the smokers are subjecting themselves to tobacco insult,” Sudbø added. But it is fairly obvious that smokers with cardiovascular risks may want to stay away from NSAID without proper advice from their generaly physician.
The effect of the NSAIDs was best for those smokers who were considered 30 or less pack-year consumers of tobacco. A pack-year of smoking consists of averaging one pack of cigarettes per day per year. Those who smoke three packs per day for ten years, or two packs per day for 15 years are also considered 30 pack-year consumers. The effectiveness of NSAIDs diminished for smokers whose consumption was greater than 30 pack-year levels.
Sudbø and his colleagues in Norway and the United States analyzed health data on 908 individuals, half of whom had been diagnosed with squamous cell carcinoma of the oral cavity. They considered the use of six NSAIDs including aspirin, ibuprofen, naproxen (or Aleve), indomethacine, piroxicame, and ketoprofene, as well as acetaminophen. All types of NSAIDs were effective at reducing the rate of oral cancer.
Acetaminophen (paracetamol), a non-aspirin pain relief medication, was ineffective at reducing the risk of developing oral cancer among smokers.
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American Association for Cancer Research
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