Ayo-Yusuf O A, Reddy P S, van den Borne B W
Department of Community Dentistry, School of Dentistry, Oral and Dental Hospital, University of Pretoria, P.O. Box 1266, Pretoria 0001, South Africa.
Tob Control. 2008 Apr;17(2):99-104. doi: 10.1136/tc.2007.022608. Epub 2008 Feb 19.
Nasal use of snuff is the predominant form of tobacco use among black South African women. This study examines the association between snuff use and chronic bronchitis (CB) among black South African women.
The study investigated a nationally representative sample of 4464 black South African women > or = 25 years old who participated in the 1998 South African Demographic and Health Survey. Data on participants' tobacco use patterns, medical history and other relevant factors were obtained through an interviewer-administered questionnaire. Peak expiratory flow rates (PEFR) were also measured. Data analysis included chi(2) statistics, Student t tests and multiple logistic regression analysis.
CB, defined as reporting a productive cough for > or = 3 months/year for at least 2 successive years.
The prevalence of current snuff use was 16.1% (n = 719). Compared to non-users of snuff, snuff users were not only more likely to present with a history of tuberculosis (TB) (23.3% vs 15.9%; p = 0.06), but they were also more likely to present with CB (5.3% vs 2.8%; p<0.01) and a lower PEFR (275 litres/min vs 293 litres/min; p<0.01). Significant determinants of CB included snuff use > 8 times/day (odds ratio (OR) 2.86, 95% CI 1.17 to 7.02), a history of TB (OR 7.23, 95% CI 4.02 to 13.03), current smoking (OR 2.84, 95% CI 1.60 to 5.04) and exposure to smoky cooking fuels (OR 1.98, 95% CI 1.32 to 2.96).
These data suggest that snuff use, in the form predominantly used in South Africa, increases the risk of CB. This challenges the idea that snuff may be a much less harmful alternative to smoking in South Africa.
在南非黑人女性中，鼻吸鼻烟是烟草使用的主要形式。本研究调查了南非黑人女性中鼻烟使用与慢性支气管炎（CB）之间的关联。
该研究调查了4464名年龄大于或等于25岁的南非黑人女性的全国代表性样本，这些女性参与了1998年南非人口与健康调查。通过访员管理的问卷获取了参与者的烟草使用模式、病史及其他相关因素的数据。还测量了呼气峰值流速（PEFR）。数据分析包括卡方统计、学生t检验和多元逻辑回归分析。
慢性支气管炎，定义为连续至少2年每年有大于或等于3个月的咳痰咳嗽。
当前鼻烟使用者的患病率为16.1%（n = 719）。与非鼻烟使用者相比，鼻烟使用者不仅更有可能有结核病（TB）病史（23.3%对15.9%；p = 0.06），而且更有可能患有慢性支气管炎（5.3%对2.8%；p<0.01）以及呼气峰值流速更低（275升/分钟对293升/分钟；p<0.01）。慢性支气管炎的显著决定因素包括每天鼻吸鼻烟超过8次（比值比（OR）2.86，95%置信区间1.17至7.02）、结核病病史（OR 7.23，95%置信区间4.02至13.03）、当前吸烟（OR 2.84，95%置信区间1.60至5.04）以及接触烟熏烹饪燃料（OR 1.98，95%置信区间1.32至2.96）。
这些数据表明，以南非主要使用的形式使用鼻烟会增加患慢性支气管炎的风险。这对鼻烟在南非可能是比吸烟危害小得多的替代品这一观点提出了挑战。
