The point estimates for the association of smoking with ASCVD were not substantially attenuated after accounting for traditional risk factors (PAD: OR, 2.84 [95% CI, 1.28-6.32]; P = .01; CAD: OR, 1.47 [95% CI, 0.52-4.18]; P = .47; stroke: OR, 3.44 [95% CI, 0.65-18.20]; P = .15), or in a model further including interleukin 6 as a marker of inflammatory risk of ASCVD (PAD: OR, 2.83 [95% CI, 1.26-6.35]; P = .01; CAD: OR, 1.48 [95% CI, 0.51-4.24]; P = .47; stroke: OR, 3.58 [95% CI, 0.69-18.70]; P = .13) compared with the univariate estimates. This evidence concerns the gene IL6 and peripheral arterial disease.