Barely Significant
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Use of smokeless tobacco and risk of myocardial infarction and stroke: systematic review with meta-analysis.

BMJ · 2009 · PMC2728803 · PMID 19690343

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a significant trendno p-value reported
Dose-response analyses for fatal myocardial infarction were reported in two studies 11 14 : in neither was there a significant trend in risk by duration or frequency of use, but in one study the relative risk of fatal myocardial infarction was highest in the group that used smokeless tobacco most often. 14 On the basis of six risk estimates the overall relative risk of stroke was 1.19 (0.97 to 1.47; test for publication bias P=1.0; table 2).

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