# Relationship Between Smoking and Angina Across Diverse Demographic and Socioeconomic Subgroups in the United States: A Retrospective Study Using the Behavioral Risk Factor Surveillance System (BRFSS) Database

## TL;DR

This study finds that smoking is linked to higher rates of angina, especially among young adults, women, and Hispanic and Black individuals in the U.S.

## Contribution

The study identifies population-specific disparities in the smoking-angina relationship using U.S. demographic and socioeconomic data.

## Key findings

- Smokers had a 1.149 higher odds of angina compared to non-smokers.
- Young adults had the highest odds (4.504) of angina associated with smoking.
- Hispanic and Black individuals showed stronger associations between smoking and angina.

## Abstract

Introduction: Coronary heart disease (CHD) is a leading cause of morbidity and mortality worldwide and commonly presents as angina. Although smoking has been studied extensively as a modifiable risk factor of CHD, the influence of specific demographic and socioeconomic factors on their relation is less well understood.

Objective: To evaluate the association between smoking and angina or CHD, with particular attention to demographic and socioeconomic factors.

Methodology: A retrospective study was conducted using data from the 2022 Behavioral Risk Factor Surveillance System (BRFSS). Only data with detailed responses to questions about smoking and angina were included. The exposure variable was current smoking status, and the outcome variable was a history of angina or CHD. Demographic variables included gender, ethnicity, and age, whereas annual income and education were included as socioeconomic variables. Statistical analyses were performed to evaluate the relationship between smoking and angina/CHD.

Results: A total of 405,798 respondents’ data were included from 445,132 participants. A significant association was found between smoking and angina, with an odds ratio (OR) of 1.149 and a 95% confidence interval (CI) of 1.106-1.193 when comparing smokers and non-smokers. Higher odds of association were found among young adults (OR = 4.504; CI 2.6523-7.3709), females (OR = 1.356; CI 1.2806-1.435), Hispanic individuals (OR = 1.502, 95% CI 1.3505-1.6668), Black individuals (OR = 1.214, 95% CI 1.0519-1.3967), and individuals with advanced education (OR = 1.186, 95% CI 1.1255-1.2494).

Conclusions: The findings of this study suggest that angina/CHD was reported significantly more frequently among smokers than non-smokers. The stronger associations observed in young adults, females, and Hispanic and Black individuals highlight the need for population-specific targeted interventions.