Hirayama Fumi, Lee Andy H, Binns Colin W, Tanikawa Yoshimasa
National Drug Research Institute, Curtin University of Technology, Perth, Australia.
Addict Behav. 2008 Sep;33(9):1235-8. doi: 10.1016/j.addbeh.2008.04.014. Epub 2008 May 8.
This study ascertained the smoking prevalence and factors affecting continuous smoking by Japanese patients within four years from diagnosis of chronic obstructive pulmonary disease (COPD). Of the 300 patients referred from six hospitals in central Japan, 276 eligible participants (mean age 66.5 years, SD 6.7) were interviewed for their habitual cigarette consumption. Overall, 22.5% of patients were current smokers but the prevalence appeared to decrease from <1 year (24.5%) to 2-4 years (19%) after diagnosis. They had smoked on average for 41 (SD 11) years and 89% of the current smokers smoked daily. Continuous smoking was inversely associated with age (odds ratio (OR)=0.94, 95% CI 0.90-0.98), body mass index (OR=0.88, 95% CI 0.80-0.97) and disease severity (OR=0.29, 95% CI 0.12-0.74 for severe COPD and OR=0.29, 95% CI 0.09-0.92 for very severe COPD). It is alarming to find mild and moderate COPD patients continue to smoke. The implementation of a co-ordinated tobacco control program immediately post diagnosis is needed for the effective pulmonary rehabilitation of COPD patients.
本研究确定了日本慢性阻塞性肺疾病（COPD）患者自诊断后四年内的吸烟率及影响持续吸烟的因素。在从日本中部六家医院转诊的300例患者中，对276名符合条件的参与者（平均年龄66.5岁，标准差6.7）进行了习惯性吸烟情况的访谈。总体而言，22.5%的患者为当前吸烟者，但患病率似乎从诊断后<1年（24.5%）降至2 - 4年（19%）。他们平均吸烟41年（标准差11），89%的当前吸烟者每天吸烟。持续吸烟与年龄呈负相关（优势比（OR）=0.94，95%置信区间0.90 - 0.98）、体重指数呈负相关（OR = 0.88，95%置信区间0.80 - 0.97）以及疾病严重程度呈负相关（重度COPD的OR = 0.29，95%置信区间0.12 - 0.74；极重度COPD的OR = 0.29，95%置信区间0.09 - 0.92）。发现轻度和中度COPD患者继续吸烟令人担忧。为了COPD患者的有效肺康复，需要在诊断后立即实施协调的烟草控制计划。
