Open Access Research article

Cumulative smoking exposure, duration of smoking cessation, and peripheral arterial disease in middle-aged and older Korean men

Young-Hoon Lee1, Min-Ho Shin2*, Sun-Seog Kweon23, Jin-Su Choi2, Jung-Ae Rhee2, Hye-Ran Ahn2, Woo-Jun Yun2, So-Yeon Ryu4, Bok-Hee Kim5, Hae-Sung Nam6, Seul-Ki Jeong7 and Kyeong-Soo Park8

Author Affiliations

1 Regional Cardiocerebrovascular Center, Chonnam National University Hospital, Gwangju 501-757, Republic of Korea

2 Department of Preventive Medicine, Chonnam National University Medical School, Gwangju 501-746, Republic of Korea

3 Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Jeollanamdo 519-809, Republic of Korea

4 Department of Preventive Medicine, Chosun University College of Medicine, Gwangju 501-759, Republic of Korea

5 Department of Food and Nutrition, College of Natural Sciences, Chosun University, Gwangju 501-759, Republic of Korea

6 Department of Preventive Medicine, Chungnam National University College of Medicine, Daejeon 301-747, Republic of Korea

7 Department of Neurology, Chonbuk National University Medical School, Jeonju 561-180, Republic of Korea

8 Department of Preventive Medicine, Seonam University College of Medicine, Jeollabukdo 590-711, Republic of Korea

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BMC Public Health 2011, 11:94  doi:10.1186/1471-2458-11-94

Published: 11 February 2011



We investigated the association of cumulative smoking exposure and duration of smoking cessation with peripheral arterial disease (PAD).


The study population consisted of 2517 community-dwelling Korean men aged 50 years and older. Information on smoking characteristics such as smoking status, pack-years of smoking, and years since quitting smoking was collected using a standardized questionnaire. PAD was defined as an ankle-brachial index (ABI) less than 0.90 in either leg.


The odds ratio (OR, 95% confidence interval) of PAD was 2.31 (1.20-4.42) for former smokers and 4.30 (2.13-8.66) for current smokers, after adjusting for other cardiovascular risk factors. There was a significant dose-response relationship between pack-years of smoking and PAD. Compared with those who had never smoked, the multivariate-adjusted ORs of PAD for smokers of 0.1-20.0, 20.1-40.0, and >40.0 pack-years were 2.15 (1.06-4.38), 2.24 (1.08-4.65), and 2.93 (1.41-6.09), respectively. There was a significant decrease in PAD risk as the years since quitting smoking increased. The multivariate-adjusted ORs of PAD for 11-20 and ≥21 years smoking cessation were 0.41 (0.19-0.86) and 0.49 (0.24-0.98), compared with current smokers.


Cumulative smoking exposure and duration of smoking cessation were significantly associated with PAD in middle aged and older Korean men.