Khan SS, Ning H, Sinha A, et al. - Findings revealed that current smoking was related to a fatal event as the first manifestation of clinical cardiovascular disease (CVD).

• Cigarette smoking is significantly linked with premature death associated and not associated with CVD.

• By pooling and harmonizing individual‐level data from 9 population‐based cohorts in the United States, experts investigated if risk related to smoking is similar across CVD subtypes and how this translates into years of life lost.

• Among 106,165 adults (50.4% were women) who were free of clinical CVD at baseline, the overall long‐term risks for CVD events were estimated to be 46.0% and 34.7% in middle‐aged men and women, respectively.

• Among middle‐aged males who reported smoking vs those who did not smoke, competing hazard ratios (HRs) were found to be higher for the first presentation being a fatal CVD event (HR, 1.79), with a similar pattern among females (HR,1.82).

• Smoking was identified to be linked with earlier CVD onset by 5.1 and 3.8 years in males and females.

• There were similar patterns in younger and older adults.