Research Institute for a Tobacco Free Society, Dublin 8, Ireland.
QJM. 2010 Mar;103(3):163-8. doi: 10.1093/qjmed/hcp190. Epub 2010 Jan 31.
Chronic Obstructive Pulmonary Disease (COPD) causes a huge economic burden and >80% of COPD cases are attributable to smoking. Massachusetts introduced a comprehensive Tobacco Control Program (MTCP) in January 1993. A trend analysis of COPD hospitalization rates might indirectly reflect the potential impact of such comprehensive tobacco control programs.
Age-adjusted COPD hospitalization rates/100,000 was abstracted from the Massachusetts Community Health Information Profile Database between 1989 and 2005. Joinpoint Regression Analyses program was employed to estimate annual percent changes (APC) in COPD rates by age, sex and race.
In 1989, 265/100,000 age-adjusted COPD hospitalization rates were reported that increased to 423/100,000 in 1993, and then declined to 329/100,000 in 2005. A significant annual decline of 5.6 percentage points was observed in overall COPD rates from 1993 onwards. A similar temporal pattern, with an age-gradient and a slower annual decline in female COPD rates relative to male COPD rates, was observed. COPD rates in both Blacks and Whites were similar to the general overall pattern. Such consistent annual declines in COPD hospitalization rates from 1993 onwards in Massachusetts also closely correspond to the introduction of the MTCP in January 1993.
The findings indirectly suggest that smoking cessation should remain the cornerstone strategy for the prevention and control of COPD burden. However, additional studies across different population settings are essential for a definitive conclusion with regard to the immediate impact of a comprehensive tobacco control program on COPD hospitalization rates showing possible gender susceptibility.
慢性阻塞性肺疾病（COPD）造成了巨大的经济负担，超过 80%的 COPD 病例归因于吸烟。马萨诸塞州于 1993 年 1 月推出了一项全面的烟草控制计划（MTCP）。COPD 住院率的趋势分析可能间接反映此类全面烟草控制计划的潜在影响。
从 1989 年至 2005 年，从马萨诸塞州社区健康信息档案数据库中提取年龄调整后 COPD 住院率/每 10 万人。使用 Joinpoint 回归分析程序估计 COPD 发病率的年度百分比变化（APC），按年龄、性别和种族进行分析。
1989 年，报告了每 10 万人中有 265 例年龄调整后 COPD 住院率，1993 年增至每 10 万人中有 423 例，然后在 2005 年降至每 10 万人中有 329 例。1993 年以来，总体 COPD 发病率每年下降 5.6 个百分点。观察到一个类似的时间模式，即女性 COPD 发病率相对于男性 COPD 发病率呈年龄梯度，且每年下降速度较慢。黑人和白人的 COPD 发病率与总体模式相似。马萨诸塞州自 1993 年以来 COPD 住院率持续每年下降，这一发现间接表明，戒烟应仍然是预防和控制 COPD 负担的基石策略。然而，在不同人群环境中进行更多研究对于确定全面烟草控制计划对 COPD 住院率的直接影响至关重要，这可能存在性别易感性。
