Department of Respiratory Therapy, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Riyadh 11481, Saudi Arabia.
King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia.
Int J Environ Res Public Health. 2021 Dec 31;19(1):408. doi: 10.3390/ijerph19010408.
Despite the advancements in chronic obstructive pulmonary disease (COPD) treatment, complications related to COPD exacerbation remain challenging. One associated factor is substance use/misuse among adults with COPD. Fewer studies, however, examined the prevalence and association between COPD and substance use and misuse. In addition, limited knowledge existed about the moderation effects of serious psychological distress and gender among adults with COPD and substance use/misuse. We aimed, therefore, to measure such prevalence, association, and moderation from nationally representative samples in the United States.
Data were drawn from the 2015-2019 National Survey on Drug Use and Health. Weighted logistic regressions were used to measure the associations of last-month tobacco (cigarettes, cigars, pipe, and smokeless tobacco products), other licit and illicit substance use (alcohol, marijuana, cocaine, crack, heroin, hallucinogens, and inhalants), and substance misuse (pain relievers, tranquilizers, stimulants, and sedatives) among adults with COPD. Serious psychological distress and gender were tested as moderators in the association between COPD and substance use/misuse.
The findings revealed that adults with COPD [ = 53,115,718) revealed greater odds of cigarettes [adjusted odds ratio (aOR) = 2.48 (95%CI = 1.80-3.42)) and smokeless tobacco (aOR = 3.65 (95%CI = 1.75-7.65)). However, they were less likely to use alcohol (aOR = 0.61 (95%CI = 0.45-0.84)). Adults with COPD who had serious psychological distress were more likely to use pipe tobacco and alcohol; however, they were less likely to use hallucinogens and inhalants. Finally, males compared to females with COPD were less likely to use smokeless tobacco.
Adults with COPD in the United States were more likely to use tobacco products and less likely to use alcohol. In addition, serious psychological distress and gender were moderators in associations between COPD and substance use but not in substance misuse. Future studies should longitudinally assess the factors that may contribute to the initiation and progression of substance use and misuse among adults with COPD.
尽管在慢性阻塞性肺疾病（COPD）治疗方面取得了进展，但与 COPD 加重相关的并发症仍然具有挑战性。一个相关因素是 COPD 患者中的物质使用/滥用。然而，较少的研究检查了 COPD 与物质使用和滥用之间的患病率和关联。此外，对于 COPD 患者物质使用/滥用中严重心理困扰和性别之间的调节作用知之甚少。因此，我们的目的是从美国具有全国代表性的样本中衡量这种患病率、关联和调节作用。
数据来自 2015-2019 年全国毒品使用与健康调查。使用加权逻辑回归来衡量 COPD 患者上个月使用烟草（香烟、雪茄、烟斗和无烟烟草制品）、其他合法和非法物质（酒精、大麻、可卡因、快克、海洛因、迷幻剂和吸入剂）以及物质滥用（止痛药、镇静剂、兴奋剂和镇静剂）的关联。严重心理困扰和性别被测试为 COPD 与物质使用/滥用之间关联的调节因素。
研究结果表明，患有 COPD 的成年人[ = 53,115,718）]使用香烟的几率更高[调整后的优势比（aOR）= 2.48（95%CI = 1.80-3.42）]和无烟烟草（aOR = 3.65（95%CI = 1.75-7.65））。然而，他们使用酒精的可能性较小（aOR = 0.61（95%CI = 0.45-0.84））。患有严重心理困扰的 COPD 成年人更有可能使用烟斗烟草和酒精；然而，他们不太可能使用迷幻剂和吸入剂。最后，与患有 COPD 的女性相比，男性不太可能使用无烟烟草。
美国患有 COPD 的成年人更有可能使用烟草制品，而不太可能使用酒精。此外，严重心理困扰和性别是 COPD 与物质使用之间关联的调节剂，但不是物质滥用的调节剂。未来的研究应该纵向评估可能导致 COPD 患者物质使用和滥用开始和进展的因素。
