Physiopathology and Epidemiology Cerebro-cardiovascular (PEC2, EA 7460), Faculty of Health Science (UFR des Sciences de Santé), University Burgundy and Franche-Comté, Dijon, France; Outpatient Addictology Center, AP-HP Center, University of Paris, Paris, France; Groupement d'intérêt Scientifique du Réseau français d'excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France.
Physiopathology and Epidemiology Cerebro-cardiovascular (PEC2, EA 7460), Faculty of Health Science (UFR des Sciences de Santé), University Burgundy and Franche-Comté, Dijon, France; Groupement d'intérêt Scientifique du Réseau français d'excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France.
Am J Prev Med. 2022 Nov;63(5):800-808. doi: 10.1016/j.amepre.2022.04.028. Epub 2022 Jun 27.
Smoking is particularly harmful to the cardiovascular system, and smoking-cessation is a key target for cardiovascular prevention. From a large nationwide database on subjects who visited smoking-cessation services, this study assessed the profile and abstinence rate comparing female with male smokers at high cardiovascular risk.
This was an observational study from the French smoking-cessation services cohort (French national cohort Consultations de Dépendance Tabagique) between 2001 and 2018. Inclusion criteria were being aged ≥18 years and having ≥1 cardiovascular risk factor. Abstinence was self-reported (stopping cigarettes or other tobacco products use ≥28 consecutive days) and confirmed by exhaled carbon monoxide <10 parts per million. Analysis was conducted in 2021.
Among 36,864 people who smoke, 15,407 (42%) were women. Women were 3 years younger (48 vs 51 years, p<0.001) and more educated (≥high school diploma: 54% vs 45%, p<0.001) than men. The burden of cardiovascular risk factors was slightly lower in women than in men and, for hypercholesterolemia, hypertension, diabetes, and cardiovascular diseases, were half as frequent in women as they were in men (16% vs 32%, p<0.001). However, women suffered more often from obesity, respiratory diseases, and anxiety‒depression symptoms (53% vs 39%, p<0.001). Finally, although women were less nicotine dependent, their abstinence rate was slightly lower (52.6% vs 55.2%, p<0.001).
Women who smoked had a high burden of risk factors, especially obesity and elevated rates of lung diseases, and a lower abstinence rate, with more common anxiety‒depression symptoms. Men who smoked had a higher prevalence of cardiovascular disease, higher nicotine dependence, and coaddictions. These findings highlight the need to strengthen cardiovascular prevention strategies through comprehensive sex-tailored smoking-cessation interventions.
吸烟对心血管系统尤其有害，戒烟是心血管预防的关键目标。本研究从一个全国性的关于就诊于戒烟服务人群的大型数据库中，评估了比较高心血管风险的女性和男性吸烟者的特征和戒烟率。
这是一项 2001 年至 2018 年期间进行的法国戒烟服务队列（法国全国咨询依赖于吸烟队列）的观察性研究。纳入标准为年龄≥18 岁和存在≥1 个心血管危险因素。通过呼气一氧化碳<10ppm 来自我报告（停止吸烟或其他烟草制品使用≥28 天）并确认。分析于 2021 年进行。
在 36864 名吸烟者中，15407 名（42%）为女性。女性比男性年轻 3 岁（48 岁比 51 岁，p<0.001），受教育程度更高（≥高中文凭：54%比 45%，p<0.001）。女性心血管危险因素负担略低于男性，且高胆固醇血症、高血压、糖尿病和心血管疾病的发生率是男性的一半（16%比 32%，p<0.001）。然而，女性更常患有肥胖症、呼吸道疾病和焦虑抑郁症状（53%比 39%，p<0.001）。最后，尽管女性尼古丁依赖程度较低，但她们的戒烟率略低（52.6%比 55.2%，p<0.001）。
吸烟的女性有很高的危险因素负担，尤其是肥胖症和肺部疾病的发病率较高，以及较低的戒烟率，伴有更常见的焦虑抑郁症状。吸烟的男性则更常见心血管疾病，尼古丁依赖程度更高，且存在共病。这些发现强调了需要通过综合的性别针对性戒烟干预措施来加强心血管预防策略。
