Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain.
Department of Preventive Medicine and Public Health, Universidade de Santiago de Compostela, Santiago de Compostela, Spain; Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública - CIBERESP), Madrid, Spain; Health Research Institute of Santiago de Compostela (Instituto de Investigación Sanitaria de Santiago de Compostela - IDIS), Santiago de Compostela, Spain.
Arch Bronconeumol. 2023 Nov;59(11):717-724. doi: 10.1016/j.arbres.2023.07.009. Epub 2023 Jul 14.
There is still uncertainty about which aspects of cigarette smoking influence the risk of Chronic Obstructive Pulmonary Disease (COPD). The aim of this study was to estimate the COPD risk as related to duration of use, intensity of use, lifetime tobacco consumption, age of smoking initiation and years of abstinence.
We conducted an analytical cross-sectional study based on data from the EPISCAN-II study (n=9092). All participants underwent a face-to-face interview and post-bronchodilator spirometry was performed. COPD was defined as post-bronchodilator FEV1/FVC<70%. Parametric and nonparametric logistic regression models with generalized additive models were used.
8819 persons were included; 858 with COPD and 7961 without COPD. The COPD risk increased with smoking duration up to ≥50 years [OR 3.5 (95% CI: 2.3-5.4)], with smoking intensity up to ≥39cig/day [OR 10.1 (95% CI: 5.3-18.4)] and with lifetime tobacco consumption up to >29 pack-years [OR 3.8 (95% CI: 3.1-4.8)]. The COPD risk for those who started smoking at 22 or later was 0.9 (95% CI: 0.6-1.4). The risk of COPD decreased with increasing years of cessation. In comparison with both never smokers and current smokers, the lowest risk of COPD was found after 15-25 years of abstinence.
COPD risk increases with duration, intensity, and lifetime tobacco consumption and decreases importantly with years of abstinence. Age at smoking initiation shows no effect. After 15-25 years of cessation, COPD risk could be equal to that of a never smoker. This work suggests that the time it takes to develop COPD in a smoker is about 30 years.
目前仍不确定吸烟的哪些方面会影响慢性阻塞性肺疾病（COPD）的风险。本研究的目的是估计与吸烟时间、吸烟强度、终生吸烟量、开始吸烟年龄和戒烟年限相关的 COPD 风险。
我们进行了一项基于 EPISCAN-II 研究（n=9092）数据的分析性横断面研究。所有参与者均接受了面对面访谈和支气管扩张剂后肺量测定。COPD 的定义为支气管扩张剂后 FEV1/FVC<70%。使用参数和非参数逻辑回归模型与广义加性模型进行分析。
共纳入 8819 人，其中 858 人患有 COPD，7961 人无 COPD。COPD 风险随吸烟时间增加至≥50 年而增加[比值比（OR）3.5（95%可信区间：2.3-5.4）]，随吸烟强度增加至≥39 支/天[OR 10.1（95%可信区间：5.3-18.4）]和随终生吸烟量增加至>29 包年[OR 3.8（95%可信区间：3.1-4.8）]。起始吸烟年龄为 22 岁或更晚的人，COPD 风险为 0.9（95%可信区间：0.6-1.4）。随着戒烟年限的增加，COPD 的风险降低。与从不吸烟者和当前吸烟者相比，戒烟 15-25 年后 COPD 的风险最低。
COPD 风险随吸烟时间、吸烟强度和终生吸烟量的增加而增加，随戒烟年限的增加而显著降低。起始吸烟年龄无影响。戒烟 15-25 年后，COPD 的风险可能与从不吸烟者相同。这表明吸烟者发展为 COPD 大约需要 30 年。
