Center for Health Equity, Department of Information and Decision Sciences, California State University-San Bernardino, San Bernardino, CA 92407, USA.
Center for Health Equity, Department of Health Science & Human Ecology, California State University-San Bernardino, San Bernardino, CA 92407, USA.
Int J Environ Res Public Health. 2022 Apr 21;19(9):5036. doi: 10.3390/ijerph19095036.
Tobacco smoke has been associated with negative health outcomes, including those with chronic respiratory illnesses, such as asthma. This study aimed to assess the relationship between exposure to environmental tobacco smoke (ETS), as well as tobacco use (cigarette and electronic cigarettes), on asthma severity among adults with current asthma, with stratification by sex to understand potential biological sex differences.
The study population consisted of Californian adults 18 years or older with self-reported physician/health care diagnosis of asthma and still having current asthma from 2020 California Health Interview Survey. All descriptive statistics and analyses were sex-stratified and survey-weighted. Crosstabulations were used to understand the association between asthma attack and ETS or firsthand smoke exposure, while binary logistic regression models were used to assess the effect of ETS exposure, current smoking status, and control variables on asthma attack in the past 12 months, with a sub-analysis among non-smoking adults with asthma.
Among the primary variable of interest, 35% of males and 30% of females reported ETS exposure in the past 12 months, while 13% of males and 6% of females reported being a current smoker. Past year asthma attack was reported among 43% and 55% of males and females, respectively. Among males, after adjusting for all control variables, asthma attack was significantly higher among those with ETS exposure (OR: 1.75, 95% CI: 1.01-3.02) and among current smokers (OR: 3.82, 95% CI: 1.49, 9.81). Male non-smokers with ETS exposure had a 109% higher odds of asthma attack, compared to non-exposure individuals.
Using a population-based survey, our results highlight the ongoing burden of tobacco use and exposure particularly among males with current asthma, further corroborate the literature on the relationship between tobacco and asthma, and highlight putative sex-specific outcomes.
烟草烟雾与负面健康结果有关，包括慢性呼吸系统疾病，如哮喘。本研究旨在评估环境烟草烟雾（ETS）暴露以及烟草使用（香烟和电子烟）与当前哮喘成人哮喘严重程度之间的关系，同时按性别分层以了解潜在的生物学性别差异。
研究人群包括来自 2020 年加利福尼亚健康访谈调查的 18 岁或以上、自我报告有医生/医疗保健诊断为哮喘且仍患有当前哮喘的加利福尼亚成年人。所有描述性统计和分析均按性别分层和调查加权。交叉表用于了解哮喘发作与 ETS 或第一手烟雾暴露之间的关联，而二元逻辑回归模型用于评估 ETS 暴露、当前吸烟状况和控制变量对过去 12 个月内哮喘发作的影响，同时在非吸烟哮喘成年人中进行亚分析。
在主要感兴趣的变量中，35%的男性和 30%的女性报告在过去 12 个月内接触 ETS，而 13%的男性和 6%的女性报告目前吸烟。分别有 43%和 55%的男性和女性报告过去一年有哮喘发作。在男性中，调整所有控制变量后，暴露于 ETS 的哮喘发作显著更高（OR：1.75，95%CI：1.01-3.02）和当前吸烟者（OR：3.82，95%CI：1.49，9.81）。与非暴露个体相比，暴露于 ETS 的男性非吸烟者哮喘发作的可能性高出 109%。
使用基于人群的调查，我们的结果强调了烟草使用和暴露的持续负担，特别是在当前有哮喘的男性中，进一步证实了烟草与哮喘之间的关系的文献，并强调了可能的性别特异性结果。
