Department of Allied Health Sciences, University of Connecticut, Storrs, CT.
Department of Nutritional Sciences, School of Health Professions, Rutgers University, Newark, NJ.
Nicotine Tob Res. 2019 May 21;21(6):818-827. doi: 10.1093/ntr/ntx242.
Population-based studies show inconsistent effects of cigarette smoking on olfactory function. We aimed to identify direct and indirect associations between measures of smoking exposure/nicotine dependence and altered olfaction in a nationally representative sample of adults.
NHANES 2011-2014 (n = 7418) participants (mean age = 57.8 ± 12.2 years) self-reported olfaction and related health and demographic risks. Affirmative answers to three questions defined altered olfaction (olfactory problems in the past years; worse ability since age 25; phantom smells). Smoking (never, former, current) was self-reported by chronicity (pack years, PY) and dependency (time to first cigarette upon waking) and verified by serum cotinine. Associations were tested with logistic regression, reporting odds ratios (ORs) and 95% confidence intervals (CIs), and mediation models.
Estimated prevalence of altered olfaction was 22.3%, with age-related increases. Nearly half of the sample were former/current smokers (47.4%). Controlling for olfactory-related risks, ≥10 PY smokers had significantly greater odds of altered olfaction versus never smokers (OR 1.36, CI: 1.06-1.74). The odds of altered olfaction were heightened among current smokers (≥10 PY) who also had high nicotine dependence (smoked ≤30 min of waking) (OR 1.41, CI: 1.01-1.99). Light smokers (≤10 PY smokers) did not show increased odds versus never smokers. Current smokers who also were heavy drinkers (≥4 drinks/day) had the highest odds for altered olfaction (OR 1.96, CI: 1.20-3.19). Olfactory-related pathologies (sinonasal problems, serious head injury, tonsillectomy, xerostomia) partially mediated the association between smoking and altered olfaction.
Chronic cigarette smoking was associated with increased odds of self-reported olfactory alterations, directly and indirectly via olfactory-related pathologies.
Analysis of the US nationally representative data revealed significant positive associations between chronic smoking and alterations in the sense of smell. Rates of smell alteration (self-reported problems in the past year, losses with aging, and phantom smells) increased from 23% among adults to 33% for chronic smokers and 38% for chronic smokers who also reported heavy drinking. Chronic smoking showed associations with smell alteration that were direct and indirect through exposure to olfactory-related pathologies (naso-sinus problems, dry mouth, head/facial injury). Smell alteration can impact smokers' quality of life by challenging the ability to sense warning odors, food flavor, and olfactory-stimulated emotions and memories.
基于人群的研究表明，吸烟对嗅觉功能的影响不一致。我们旨在确定在具有全国代表性的成年人样本中，吸烟暴露/尼古丁依赖的测量值与嗅觉改变之间的直接和间接关联。
NHANES 2011-2014（n=7418）参与者（平均年龄=57.8±12.2 岁）自我报告嗅觉及其相关健康和人口统计学风险。过去几年嗅觉问题；25 岁以后能力下降；幻嗅）三个问题的肯定回答定义了嗅觉改变。吸烟（从不、以前、现在）通过慢性（包年数，PY）和依赖性（醒来后第一支烟的时间）自我报告，并通过血清可替宁验证。使用逻辑回归测试关联，报告比值比（OR）和 95%置信区间（CI），并进行中介模型分析。
嗅觉改变的估计患病率为 22.3%，随年龄增长而增加。近一半的样本是前/现吸烟者（47.4%）。控制嗅觉相关风险后，与从不吸烟者相比，≥10 PY 的吸烟者发生嗅觉改变的几率显著更高（OR 1.36，CI：1.06-1.74）。目前吸烟（≥10 PY）且尼古丁依赖性高（醒来后吸烟≤30 分钟）的吸烟者发生嗅觉改变的几率更高（OR 1.41，CI：1.01-1.99）。轻度吸烟者（≤10 PY 吸烟者）与从不吸烟者相比，没有增加的几率。目前吸烟且重度饮酒者（≥4 杯/天）发生嗅觉改变的几率最高（OR 1.96，CI：1.20-3.19）。嗅觉相关病理学（鼻-鼻窦问题、严重头部损伤、扁桃体切除术、口干）部分介导了吸烟与嗅觉改变之间的关联。
慢性吸烟与自我报告的嗅觉改变的几率增加有关，直接和间接通过嗅觉相关的病理学。
对美国全国代表性数据的分析显示，慢性吸烟与嗅觉的改变之间存在显著的正相关关系。嗅觉改变（过去一年报告的问题、与年龄相关的丧失和幻嗅）的发生率从成年人的 23%增加到慢性吸烟者的 33%，再到慢性吸烟者和重度饮酒者的 38%。慢性吸烟与嗅觉改变之间存在直接和间接的关联，这种关联通过暴露于嗅觉相关的病理学（鼻-鼻窦问题、口干、头部/面部损伤）。嗅觉改变会影响吸烟者的生活质量，因为它会挑战对警告气味、食物味道和嗅觉刺激情绪和记忆的感知能力。
