Differential Assessment of the Global Tobacco Index and Smoking Intensity and Duration on Blood Pressure in Peruvian Adults

Introduction: Smoking is a known risk factor for cardiovascular diseases, but its specific relationship with blood pressure remains a topic of debate. Recent studies suggest that different aspects of smoking behavior, such as intensity and duration, may have distinct effects on blood pressure. Objective: To evaluate the association between different measures of smoking behavior and blood pressure in the Peruvian population. Methodology: A cross-sectional analysis was conducted using data from the Peruvian Demographic and Family Health Survey (DHS) from 2018 to 2023. Multiple aspects of smoking were assessed, including current smoking status, intensity, duration, and the global tobacco index. Multiple linear regression models were used to examine the association between these measures and systolic (SBP) and diastolic (DBP) blood pressure, adjusting for sociodemographic and health variables. Results: A significant association was found between smoking intensity and elevated blood pressure. Smokers of 20 or more cigarettes per day showed an increase of 6.82 mmHg in SBP (95% CI: 2.90, 10.75) and 5.07 mmHg in DBP (95% CI: 2.44, 7.70) compared to non-smokers. The global tobacco index and smoking duration showed weaker and more variable associations with blood pressure. Conclusions: Smoking intensity, rather than other measures of smoking behavior, is more strongly associated with blood pressure levels. These findings highlight the importance of considering smoking intensity in cardiovascular risk assessment and suggest that prevention strategies should focus not only on cessation but also on reducing smoking intensity.