电子烟使用与吸烟状况的慢性阻塞性肺疾病的关联：行为风险因素监测系统 2016 年和 2017 年。
Association Between E-Cigarette Use and Chronic Obstructive Pulmonary Disease by Smoking Status: Behavioral Risk Factor Surveillance System 2016 and 2017.
机构信息
American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas; Department of Medicine, Johns Hopkins University, Baltimore, Maryland.
Department of Medicine, Johns Hopkins University, Baltimore, Maryland; Department of Radiology and Neuroradiology, Charité, Berlin, Germany.
出版信息
Am J Prev Med. 2020 Mar;58(3):336-342. doi: 10.1016/j.amepre.2019.10.014. Epub 2020 Jan 2.
INTRODUCTION
The association between e-cigarette use and chronic bronchitis, emphysema, and chronic obstructive pulmonary disease has not been studied thoroughly, particularly in populations defined by concomitant combustible smoking status.
METHODS
Using pooled 2016 and 2017 data from the Behavioral Risk Factor Surveillance System, investigators studied 705,159 participants with complete self-reported information on e-cigarette use, combustible cigarette use, key covariates, and chronic bronchitis, emphysema, or chronic obstructive pulmonary disease. Current e-cigarette use was the main exposure, with current use further classified as daily or occasional use. The main outcome was defined as reported ever having a diagnosis of chronic bronchitis, emphysema, or chronic obstructive pulmonary disease. For all the analyses, multivariable adjusted logistic regression was used, with the study population stratified by combustible cigarette use status (never, former, or current). All the analyses were conducted in 2019.
RESULTS
Of 705,159 participants, 25,175 (3.6%) were current e-cigarette users, 64,792 (9.2%) current combustible cigarette smokers, 207,905 (29.5%) former combustible cigarette smokers, 432,462 (61.3%) never combustible cigarette smokers, and 14,036 (2.0%) dual users of e-cigarettes and combustible cigarettes. A total of 53,702 (7.6%) participants self-reported chronic bronchitis, emphysema, or chronic obstructive pulmonary disease. Among never combustible cigarette smokers, current e-cigarette use was associated with 75% higher odds of chronic bronchitis, emphysema, or chronic obstructive pulmonary disease compared with never e-cigarette users (OR=1.75, 95% CI=1.25, 2.45), with daily users of e-cigarettes having the highest odds (OR=2.64, 95% CI=1.43, 4.89). Similar associations between e-cigarette use and chronic bronchitis, emphysema, or chronic obstructive pulmonary disease were noted among both former and current combustible cigarette smokers.
CONCLUSIONS
The results suggest possible e-cigarette-related pulmonary toxicity across all the categories of combustible cigarette smoking status, including those who had never smoked combustible cigarettes.
简介
电子烟使用与慢性支气管炎、肺气肿和慢性阻塞性肺疾病之间的关联尚未得到充分研究，特别是在同时存在可燃吸烟状况的人群中。
方法
利用行为风险因素监测系统 2016 年和 2017 年的汇总数据，研究人员对 705159 名参与者进行了研究，这些参与者提供了完整的电子烟使用、可燃香烟使用、关键协变量以及慢性支气管炎、肺气肿或慢性阻塞性肺疾病的自我报告信息。目前的电子烟使用是主要暴露因素，进一步将目前的使用分为每日使用或偶尔使用。主要结果定义为报告曾患有慢性支气管炎、肺气肿或慢性阻塞性肺疾病。在所有分析中，使用多变量调整的逻辑回归，根据可燃香烟使用状况（从不、以前或目前）对研究人群进行分层。所有分析均于 2019 年进行。
结果
在 705159 名参与者中，25175 名（3.6%）为目前的电子烟使用者，64792 名（9.2%）为目前的可燃香烟吸烟者，207905 名（29.5%）为以前的可燃香烟吸烟者，432462 名（61.3%）为从不使用可燃香烟者，14036 名（2.0%）为电子烟和可燃香烟的双重使用者。共有 53702 名（7.6%）参与者自我报告患有慢性支气管炎、肺气肿或慢性阻塞性肺疾病。在从不使用可燃香烟的人群中，与从不使用电子烟者相比，目前使用电子烟与慢性支气管炎、肺气肿或慢性阻塞性肺疾病的可能性增加 75%（OR=1.75，95%CI=1.25，2.45），电子烟每日使用者的可能性最高（OR=2.64，95%CI=1.43，4.89）。在以前和目前的可燃香烟吸烟者中，电子烟使用与慢性支气管炎、肺气肿或慢性阻塞性肺疾病之间也存在类似的关联。
结论
结果表明，电子烟可能与所有可燃香烟吸烟状况类别的肺部毒性有关，包括那些从未吸过可燃香烟的人。
Zotero 插件