Association of Self-Reported and Cotinine-Verified Smoking Status with Atrial Arrhythmia

BACKGROUND: The relationship between self-reported and urinary cotinine-verified smoking status and atrial arrhythmia (AA) is unclear. The aim of this study was to evaluate the association of self-reported and urine cotinine-verified smoking status with AA. METHOD: A total of 201,788 participants (106,375 men, mean age 37 years) who had both a urinary cotinine measurement and electrocardiogram were included. Cotinine-verified current smoking was defined as a urinary cotinine level above 50 ng/mL. Individuals were divided into three groups based on self-reported smoking and two groups based on cotinine-verified smoking status. RESULTS: Among overall subjects, 505 had documented AA (0.3%) and 135 had atrial fibrillation (AF) (0.1%). Self-reported current smoking was associated with an increased risk of AA (odds ratio [OR], 1.42; 95% confidence interval [CI], 1.06–1.91; P = 0.019) and AF (OR, 2.20; 95% CI, 1.24–3.90; P = 0.007), whereas self-reported former smoking had no significant association with AA (OR, 1.30; 95% CI, 0.97–1.73; P = 0.078) and AF (OR, 1.74; 95% CI, 1.00–3.04; P = 0.051). Cotinine-verified current smoking showed no significant association with AA (OR, 1.24; 95% CI, 0.98–1.58; P = 0.080) and AF (OR, 1.20; 95% CI, 0.79–1.83; P = 0.391). CONCLUSION: Self-reported current smoking was associated with AA and AF, while self-reported former smoking and cotinine-verified current smoking showed no significant association with AA and AF.