Song Ge PhD, RN, BSN, and Linda Dune, BSN, RN, MSN, PhD, Department of Natural Sciences/Nursing, University of Houston-Downtown, Texas. Xianping Tang, PhD, School of Nursing, Xuzhou Medical University, China. Zhe Wei, MS, Stem Healthcare, York, Pennsylvania. Tingting Liu, BSN, RN, PhD, Eleanor Mann School of Nursing, University of Arkansas, Fayetteville. Junxin Li, BSN, MSN, RN, PhD, Johns Hopkins University School of Nursing, Baltimore, Maryland. Changwei Li, MD, PhD, MPH, Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens.
J Addict Nurs. 2020 Jul/Sep;31(3):E5-E12. doi: 10.1097/JAN.0000000000000352.
Smoking is prevalent among people in China. In this study, we examined the association between smoking and cognitive function in a representative sample of adults aged 45 years and older in China.
We analyzed the baseline data of 16,892 participants from the China Health and Retirement Longitudinal Study. We measured smoking based on smoking status (never, former, and current smokers) and pack years (one pack year equals 20 cigarettes per day for 1 year). We assessed cognitive function for visuospatial ability, episodic memory, orientation/attention, and overall cognitive function. Multivariate linear and logistic regressions were used to examine the independent association between smoking and cognitive function, controlling for sociodemographic factors, domestic partner status, physical health status, and depressive symptoms.
The study participants were, on average, 60 years old. The prevalence of former and current smoking in this population was 8.4% and 28.8%, respectively. Compared with nonsmokers, former and current smokers had better cognitive function (p < .0001). After controlling for covariates, only former smokers, compared with nonsmokers, have better orientation and attention (p = .04) and overall cognitive function (p = .01). Moreover, pack years are positively associated with orientation, attention (p = .04), and overall cognitive function among all participants (p = .02).
This study identified that, among middle-aged and older Chinese adults, former smokers had the highest cognitive function, especially attention and orientation, followed by never smokers and current smokers. When screening for cognition impairment among Chinese middle-aged and older adults, we should encourage them to quit smoking.
在中国，吸烟现象普遍存在。本研究旨在调查中国 45 岁及以上成年人中吸烟与认知功能之间的关系。
我们分析了中国健康与退休纵向研究的 16892 名参与者的基线数据。我们根据吸烟状况（从不吸烟者、曾经吸烟者和当前吸烟者）和吸烟包年数（1 包年指每天吸 20 支烟，持续 1 年）来衡量吸烟情况。我们评估了参与者的视空间能力、情景记忆、定向/注意力和整体认知功能。采用多元线性和逻辑回归，在控制社会人口因素、家庭伴侣状况、身体健康状况和抑郁症状的情况下，分析吸烟与认知功能之间的独立关联。
参与者的平均年龄为 60 岁。该人群中曾经和当前吸烟者的比例分别为 8.4%和 28.8%。与从不吸烟者相比，曾经和当前吸烟者的认知功能更好（p<0.0001）。在控制了混杂因素后，只有曾经吸烟者的定向和注意力（p=0.04）以及整体认知功能（p=0.01）优于从不吸烟者。此外，在所有参与者中，吸烟包年数与定向、注意力（p=0.04）和整体认知功能呈正相关（p=0.02）。
本研究发现，在中国中老年人中，与从不吸烟者和当前吸烟者相比，曾经吸烟者的认知功能最高，尤其是注意力和定向力最佳。在对中国中老年人的认知障碍进行筛查时，我们应鼓励他们戒烟。
