Goren A, Gupta S, Dong P, Feng Y, Chen C, Liu D
Kantar Health, New York, NY, USA.
Kantar Health, Princeton, NJ, USA.
Int J Clin Pract. 2015 Sep;69(9):1015-28. doi: 10.1111/ijcp.12680. Epub 2015 Jul 1.
Tobacco, widely used in China, poses a major risk for chronic obstructive pulmonary disease (COPD). This study assessed health outcomes of COPD-diagnosed smokers vs. never smokers and examined treatment patterns of patients attempting to quit smoking in urban China.
National Health and Wellness Survey (NHWS) 2010 and 2012 China data were analysed. Respondents self-reporting diagnosis with COPD, chronic bronchitis, or emphysema were categorised: quit attempters (current smokers 'trying to quit' or non-smokers 'in the process of quitting'), smokers (including quit attempters) and those who never smoked. Respondents reported smoking cessation treatment utilisation; health status: SF-36v2-based scores and SF-6D health utilities; Work Productivity and Activity Impairment questionnaire-based metrics; and resource utilisation. Regression modelling assessed health outcomes, controlling for covariates.
Among 1421 (3.6%) diagnosed respondents, 51.6% never smoked and 35.5% smoked (of whom, 43.8% were attempting to quit). After adjustments, smokers vs. never smokers had significantly lower health utilities, lower mental/physical health status and greater absenteeism, presenteeism, overall work impairment, activity impairment, emergency room visits, hospitalisations and provider visits. Quit attempters were diagnosed an average 6.9 years (SD = 7.7) previously, with 25.3% reporting moderate/severe COPD. Most-reported main causes of COPD were: smoking (57.5%), illnesses/conditions (53.8%) and pollutants (44.3%). Among quit attempters, 82.8% smoked currently. Use of prescription cessation treatments was reported by 12.7%.
Smokers experienced poorer health outcomes, reinforcing importance of prevention in mitigating disease burden. Among quit attempters, few reported using prescription cessation treatments. Given the high burden imposed by smoking in China, effective interventions may be beneficial.
烟草在中国广泛使用，是慢性阻塞性肺疾病（COPD）的主要风险因素。本研究评估了被诊断为COPD的吸烟者与从不吸烟者的健康结局，并调查了中国城市中试图戒烟的患者的治疗模式。
分析了2010年和2012年中国国家健康与 Wellness 调查（NHWS）的数据。自我报告被诊断为COPD、慢性支气管炎或肺气肿的受访者被分类为：戒烟尝试者（当前吸烟者“试图戒烟”或非吸烟者“正在戒烟过程中”）、吸烟者（包括戒烟尝试者）和从不吸烟者。受访者报告了戒烟治疗的使用情况；健康状况：基于SF - 36v2的评分和SF - 6D健康效用值；基于工作生产力和活动障碍问卷的指标；以及资源利用情况。回归模型评估了健康结局，并对协变量进行了控制。
在1421名（3.6%）被诊断的受访者中，51.6%从不吸烟，35.5%吸烟（其中，43.8%正在尝试戒烟）。调整后，吸烟者与从不吸烟者相比，健康效用值显著更低，心理/身体健康状况更低，旷工、出勤主义、总体工作障碍、活动障碍、急诊就诊、住院和就医次数更多。戒烟尝试者平均在6.9年前（标准差 = 7.7）被诊断，25.3%报告患有中度/重度COPD。报告的COPD的主要原因大多为：吸烟（57.5%）、疾病/状况（53.8%）和污染物（44.3%）。在戒烟尝试者中，82.8%目前仍在吸烟。报告使用处方戒烟治疗的比例为12.7%。
吸烟者的健康结局较差，这强化了预防在减轻疾病负担方面的重要性。在戒烟尝试者中，很少有人报告使用处方戒烟治疗。鉴于吸烟在中国造成的高负担，有效的干预措施可能会有益处。
