Liang Lirong, Li Changwei, Liu Xiaoqing, Zhou Long, Chu Shuilian, Zhang Ruiyuan, Mai Jinzhuang, Westbrook Adrianna, Li Jiachen, Zhang Di, Zhao Liancheng, Wu Yangfeng
Department of Clinical Epidemiology & Tobacco Dependence Treatment Research, Beijing Institute of Respiratory Medicine, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA.
Obesity (Silver Spring). 2022 Mar;30(3):762-769. doi: 10.1002/oby.23375. Epub 2022 Feb 11.
The aim of this study was to explore the association of lifelong smoking status with risk of major adverse cardiovascular events (MACE) accounting for weight change in a Chinese cohort.
The cohort of the People's Republic of China-United States of America (PRC-USA) Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology was established in 1983 to 1984, resurveyed during 1987 to 1988 and 1993 to 1994, and followed up to 2005. A total of 5,849 participants who survived in 1993 to 1994 were classified into never smokers, long-term quitters, short-term quitters, short-term relapsers and new smokers, long-term relapsers and new smokers, and persistent smokers according to the information on lifelong smoking status collected in all three surveys. The associations of lifelong smoking status with MACE in the subsequent 10 years were explored with Cox proportional hazards models.
During a median follow-up of 10.2 years, 694 participants had MACE. Compared with persistent smokers, the multivariable-adjusted hazard ratio of developing MACE was 0.83 (95% CI: 0.61-1.12) for short-term quitters, 0.75 (95% CI: 0.54-1.02) for long-term quitters, and 0.68 (95% CI: 0.54-0.85) for never smokers (p = 0.001). In comparison, the hazard ratio was 1.03 (95% CI: 0.77-1.35) for long-term relapsers and new smokers and 0.78 (95% CI: 0.46-1.22) for short-term relapsers and new smokers (p = 0.018). These associations were not significantly altered by further adjusting for weight change in the past 10 years.
Lifelong smoking status is significantly associated with risk of MACE. As time duration increased, health benefit to quitters would become close to that of never smokers, and harms to relapsers and new smokers would become close to that of persistent smokers.
本研究旨在探讨在中国队列中，考虑体重变化因素后，终生吸烟状态与主要不良心血管事件（MACE）风险之间的关联。
中美心血管与心肺疾病流行病学合作研究队列于1983年至1984年建立，在1987年至1988年以及1993年至1994年进行了重新调查，并随访至2005年。根据三次调查收集的终生吸烟状态信息，将1993年至1994年存活的5849名参与者分为从不吸烟者、长期戒烟者、短期戒烟者、短期复吸者和新吸烟者、长期复吸者和新吸烟者以及持续吸烟者。使用Cox比例风险模型探讨终生吸烟状态与随后10年发生MACE的关联。
在中位随访10.2年期间，694名参与者发生了MACE。与持续吸烟者相比，短期戒烟者发生MACE的多变量调整风险比为0.83（95%CI：0.61-1.12），长期戒烟者为0.75（95%CI：0.54-1.02），从不吸烟者为0.68（95%CI：0.54-0.85）（p=0.001）。相比之下，长期复吸者和新吸烟者的风险比为1.03（95%CI：0.77-1.35），短期复吸者和新吸烟者为0.78（95%CI：0.46-1.22）（p=0.018）。在进一步调整过去10年的体重变化后，这些关联没有显著改变。
终生吸烟状态与MACE风险显著相关。随着戒烟时间的延长，戒烟者的健康益处将接近从不吸烟者，而复吸者和新吸烟者的危害将接近持续吸烟者。
