Department of Obstetrics and Gynecology, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Key Laboratory of Laparoscopic Technology, the First Affiliated Hospital of Shandong First Medical University, Jinan, 250000, China.
Department of Pediatrics, Linyi People's Hospital, Linyi, 276000, China.
Environ Sci Pollut Res Int. 2023 Nov;30(51):110489-110498. doi: 10.1007/s11356-023-30175-7. Epub 2023 Oct 4.
Nicotine is a known toxin, but its relationship with cervicovaginal high-risk human papillomavirus (HR-HPV) infection is uncertain. This study aimed to investigate whether tobacco exposure is associated with elevated cervicovaginal HR-HPV infection in US women, and if the strength of this association varies with the degree of exposure. Cross-sectional data from the 2011-2016 National Health and Nutrition Examination Survey (NHANES), which included a nationally representative sample of US women, were used for the study. Out of 12436 women aged 18-59 who participated in the interview, 3833 were ultimately enrolled in this study. Weighted logistic regression was used to estimate the link between tobacco exposure and cervicovaginal HR-HPV infection. The mean age of participants was 38.6 (SD 12.1) years, and non-Hispanic White individuals accounted for 37.3% of the sample. Those with any tobacco exposure tended to be younger (mean age 37.7 [SD 12.4] years vs 40.3 [11.2] years), non-Hispanic Black (27.8% vs. 15.1%), lower educated (41.8% vs. 29.4%), and have lower family income (39.9% vs. 23.5%). After adjustment, the odds of having HR-HPV infection were 1.32 (95% CI, 1.09-1.59) for those exposed to tobacco, remaining significant in multiple sensitivity analyses and across subgroups. This study, based on a nationally representative sample from the United States, suggests that tobacco exposure is a risk factor for elevated HR-HPV infection in women, highlighting the need for further research into reducing this modifiable risk factor.
尼古丁是一种已知的毒素，但它与宫颈阴道高危型人乳头瘤病毒（HR-HPV）感染的关系尚不确定。本研究旨在调查美国女性的烟草暴露是否与宫颈阴道 HR-HPV 感染升高有关，以及这种关联的强度是否因暴露程度而异。本研究使用了 2011-2016 年全国健康和营养调查（NHANES）的横断面数据，该调查包括了美国女性的全国代表性样本。在参加访谈的 12436 名 18-59 岁的女性中，最终有 3833 名女性被纳入本研究。采用加权逻辑回归估计烟草暴露与宫颈阴道 HR-HPV 感染之间的联系。参与者的平均年龄为 38.6（SD 12.1）岁，非西班牙裔白人占样本的 37.3%。有任何烟草暴露的人往往更年轻（平均年龄 37.7[SD 12.4]岁比 40.3[11.2]岁）、非西班牙裔黑人（27.8%比 15.1%）、受教育程度较低（41.8%比 29.4%），家庭收入较低（39.9%比 23.5%）。调整后，烟草暴露者 HR-HPV 感染的几率为 1.32（95%CI，1.09-1.59），在多项敏感性分析和亚组中仍然显著。本研究基于美国的全国代表性样本，表明烟草暴露是女性 HR-HPV 感染升高的一个危险因素，突出了进一步研究减少这种可改变的危险因素的必要性。
