Department of Public Health, Graduate School, Seoul National University, Seoul, Republic of Korea.
PLoS One. 2022 Jul 8;17(7):e0270577. doi: 10.1371/journal.pone.0270577. eCollection 2022.
Dyslipidemia increases the risk of serious cardiovascular disease; and conventional cigarette smoking is widely recognized as a risk factor. Thus, as electronic cigarettes were introduced, many smokers utilized them for smoking cessation. However, due to the lack of researches scrutinized the relationship between dual smoking and dyslipidemia, a lot of those who failed in cessation end up utilizing both types of cigarettes (dual smoking). Therefore, this study aimed to examine the effect of dual smoking on dyslipidemia in South Korean adults.
Data were included from the 2013, 2014, 2015, 2016, and 2019 Korean National Health and Nutrition Examination Survey of 8,398 Korean men. The KNHANES is conducted by a national institution based on random cluster sampling, and therefore, the data gained from it is statistically reliable and representative in comparison to surveys performed by private institutions. Cigarette use status was the main independent variable. Cigarette use status was categorized as one of the four status: dual smoker, single smoker, non-smoker, and ex-smoker. The dependent variable, presence of dyslipidemia, was defined according to the National Cholesterol Education Program as displaying one or more of the following criteria: total cholesterol: ≥240 ㎎/dL, LDL cholesterol: ≥160 ㎎/dL, triglyceride: ≥200 ㎎/dL, or HDL cholesterol: ≤40 ㎎/dL. Multiple logistic regression analysis was performed to examine target association.
Current and former users of either electronic or conventional cigarettes presented with a higher odd ratio of dyslipidemia compared to non-smokers. (ex-smoker: OR = 1.60, 95% CI = 1.41-1.83; single smoker: OR = 1.21, 95% CI = 1.06-1.38). More importantly, those who smoke both conventional and electronic cigarettes were also, at high risk of dyslipidemia (dual smoker: OR = 1.66, 95% CI = 1.26-2.20). Along with smoking status, those who did not exercise had a higher risk of dyslipidemia than those who exercised regularly and higher self-reported health status was also related to a lower risk of dyslipidemia.
This study suggests that along with conventional cigarettes, dual smoking negatively impacts dyslipidemia, and smoking cessation of evert types is necessary for a healthy life.
血脂异常会增加严重心血管疾病的风险；而传统香烟被广泛认为是一个风险因素。因此，随着电子烟的推出，许多吸烟者利用电子烟戒烟。然而，由于缺乏研究来仔细研究双重吸烟与血脂异常之间的关系，许多戒烟失败的人最终会同时使用这两种香烟（双重吸烟）。因此，本研究旨在检验韩国成年人双重吸烟对血脂异常的影响。
数据来自于 2013 年、2014 年、2015 年、2016 年和 2019 年韩国全国健康和营养调查的 8398 名韩国男性。KNHANES 由一个国家机构基于随机聚类抽样进行，因此，与私人机构进行的调查相比，其数据在统计学上是可靠和具有代表性的。香烟使用状况是主要的独立变量。香烟使用状况分为以下四种状态之一：双重吸烟者、单一吸烟者、非吸烟者和前吸烟者。血脂异常的存在作为依赖变量，根据国家胆固醇教育计划定义为以下一项或多项标准：总胆固醇：≥240mg/dL、低密度脂蛋白胆固醇：≥160mg/dL、甘油三酯：≥200mg/dL 或高密度脂蛋白胆固醇：≤40mg/dL。进行多变量逻辑回归分析以检验目标关联。
目前和以前使用电子烟或传统香烟的人患血脂异常的几率高于不吸烟者。（前吸烟者：OR=1.60，95%CI=1.41-1.83；单一吸烟者：OR=1.21，95%CI=1.06-1.38）。更重要的是，同时使用传统香烟和电子烟的人也有患血脂异常的高风险（双重吸烟者：OR=1.66，95%CI=1.26-2.20）。除了吸烟状况外，不经常锻炼的人患血脂异常的风险也高于经常锻炼的人，而自我报告的健康状况较好与血脂异常的风险较低有关。
本研究表明，除了传统香烟外，双重吸烟也会对血脂异常产生负面影响，因此，为了健康的生活，需要戒烟。
