Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy.
Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), Teaching Hospital "Policlinico-V. Emanuele", University of Catania, Catania, Italy.
Intern Emerg Med. 2021 Apr;16(3):687-696. doi: 10.1007/s11739-021-02674-3. Epub 2021 Mar 23.
Given that many patients with chronic obstructive pulmonary disease (COPD) smoke despite their symptoms, it is important to understand the long-term health impact of cigarette substitution with heated tobacco products (HTPs). We monitored health parameters for 3 years in COPD patients who substantially attenuated or ceased cigarette consumption after switching to HTPs. Changes in daily cigarette smoking, annualized disease exacerbations, lung function indices, patient-reported outcomes (CAT scores) and 6-minute walk distance (6MWD) from baseline were measured in COPD patients using HTPs at 12, 24 and 36 months. These were compared to a group of age- and sex-matched COPD patients who continued smoking. Complete data sets were available for 38 patients (19 in each group). Subjects using HTPs had a substantial decrease in annualized COPD exacerbations within the group mean (± SD) from 2.1 (± 0.9) at baseline to 1.4 (± 0.8), 1.2 (± 0.8) and 1.3 (± 0.8) at 12-, 24- and 36-month follow-up (p < 0.05 for all visits). In addition, substantial and clinically significant improvements in CAT scores and 6MWD were identified at all three time points in the HTP cohort. No significant changes were observed in COPD patients who continued smoking. This study is the first to describe the long-term health effects of HTP use in COPD patients. Consistent improvements in respiratory symptoms, exercise tolerance, quality of life, and rate of disease exacerbations were observed in patients with COPD who abstained from smoking or substantially reduced their cigarette consumption by switching to HTP use.
鉴于许多慢性阻塞性肺疾病（COPD）患者尽管有症状仍吸烟，因此了解使用加热烟草产品（HTP）替代香烟对长期健康的影响很重要。我们监测了在改用 HTP 后大幅减少或停止吸烟的 COPD 患者 3 年的健康参数。在 HTP 使用 12、24 和 36 个月时，使用 HTP 的 COPD 患者测量了每日吸烟量、每年疾病加重次数、肺功能指标、患者报告的结果（CAT 评分）和 6 分钟步行距离（6MWD）与基线相比的变化。将这些数据与继续吸烟的年龄和性别匹配的 COPD 患者组进行了比较。共有 38 名患者（每组 19 名）提供了完整的数据。使用 HTP 的患者在组内平均值（±标准差）中，每年 COPD 加重的次数大幅减少，从基线时的 2.1（±0.9）降至 1.4（±0.8）、1.2（±0.8）和 1.3（±0.8），在 12、24 和 36 个月随访时（所有就诊时均为 p < 0.05）。此外，在 HTP 队列中，在所有三个时间点均观察到 CAT 评分和 6MWD 有实质性和显著改善。继续吸烟的 COPD 患者未观察到显著变化。这项研究首次描述了 HTP 在 COPD 患者中的长期健康影响。在改用 HTP 后戒烟或大幅减少吸烟量的 COPD 患者中，观察到呼吸症状、运动耐量、生活质量和疾病加重率的持续改善。
