NEW YORK (Reuters Health) - It's no secret that cigarettes increase the risk of having a heart attack, but the results of a new study suggest that this risk may be greatest in people who smoke cigarettes with high levels of tar.

In the study, smokers of "light" or regular cigarettes were at least 86% more likely to have a heart attack than smokers of "ultralight" cigarettes. Though the results suggest that switching to low-tar cigarettes could reduce the risk of heart attack, the best way for smokers to prevent a heart attack is to quit, the study's lead author told Reuters Health in an interview. "There is no such thing as a safe cigarette," said Dr. Stephen E. Kimmel of the University of Pennsylvania in Philadelphia. He noted that people who switch to low-tar cigarettes often compensate by smoking more of them or inhaling more deeply. And compared to nonsmokers, even smokers of ultralight cigarettes are much more likely to have a heart attack, he pointed out. "The only way to really reverse the risk" is to stop smoking, he stated. Tar refers to many different toxic chemicals that are found in cigarettes. In the US, "ultralight" cigarettes contain 6 milligrams (mg) or less of tar, "light" cigarettes contain 7 to 12 mg and regular cigarettes contain more than 12 mg. Some public health experts point out that all cigarettes are harmful and dismiss the labels as a marketing gimmick. Indeed, some studies have failed to show that the risk of heart attack varies by type of cigarette, but most of the studies were conducted before low-tar cigarettes became popular. In the new study, Kimmel and his colleagues compared 587 smokers who had had a heart attack with 2,685 smokers who had not had a heart attack. Compared to smokers of ultralight cigarettes, smokers of light cigarettes were 86% more likely to have a heart attack. For smokers of regular cigarettes, the risk was 121% higher. These calculations took into account several factors that could affect the risk of heart attack, including age, sex, race, body mass index and medical conditions such as high cholesterol, diabetes and a history of heart disease. And the more tar a person consumed each day, based on the type and number of cigarettes smoked each day, the greater their risk of heart attack, the researchers report in the February 11th issue of the journal Archives of Internal Medicine. Though the best way for smokers to reduce the risk of having a heart attack is to quit smoking, the findings do suggest that restricting tar levels could have some benefits, Kimmel noted. The US does not have such limits, but the European Union recently approved legislation to lower the tar limit in cigarettes from 12 mg to 10 mg. Governments "should probably consider lowering even more," according to Kimmel, who noted that smokers of 10-mg cigarettes still had a very high risk of heart attack. The research was funded by Aventis Pharmaceuticals, Novartis Consumer Health and McNeil Consumer Products Co.

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