Addictions Department, Institute of Psychiatry, Psychology & Neuroscience (IoPPN), King's College London, Addiction Sciences Building, 4 Windsor Walk, London, SE5 8BB, UK.
SPECTRUM Consortium, London, UK.
BMC Public Health. 2023 Nov 16;23(1):2263. doi: 10.1186/s12889-023-17200-7.
Electronic health records (EHRs) could identify long-term health effects of nicotine vaping. We characterised the extent to which vaping is recorded in primary care EHRs in the UK, on a population level.
We performed descriptive analysis of Clinical Practice Research Datalink (CPRD), primary care electronic health records of 25% of the UK population (~ 16 million patients). Patients aged ≥ 18 years whose vaping status was recorded using medical codes between 2006 and 2022 were identified. We reported the frequency of vaping codes; their distribution by patient age, gender, and ethnicity; trends in vaping recording over time (including interrupted time series analyses); and transitions in patient smoking status.
Seven medical codes indicated current or former vaping, from 150,114 patients. When their vaping status was first recorded, mean patient age was 50.2 years (standard deviation: 15.0), 52.4% were female, and 82.1% were White. Of those recorded as currently vaping, almost all (98.9%) had records of their prior smoking status: 55.0% had been smoking, 38.3% had stopped smoking, 5.6% had never smoked. Of those who were smoking prior to being recorded as vaping, more than a year after the vaping record, over a third (34.2%) were still smoking, under a quarter (23.7%) quit smoking, 1.7% received a 'never smoked' status, and there was no smoking status for 40.4%. The 'e-cigarette or vaping product use-associated lung injury' (EVALI) outbreak was significantly associated with a declining trend in new records of current vaping between September 2019 and March 2020; and an immediate significant increase in new records of former vaping, followed by a declining trend.
Few patients are being asked about vaping. Most who vape had smoked, and many quit smoking after starting vaping. To enable electronic health records to provide stronger evidence on health effects, we recommend improved completeness, accuracy and consistency.
电子健康记录（EHR）可识别尼古丁蒸气吸入对长期健康的影响。我们在人群水平上描述了英国初级保健 EHR 中蒸气吸入记录的程度。
我们对临床实践研究数据链（CPRD）进行了描述性分析，CPRD 是英国 25%的人口（约 1600 万患者）的初级保健电子健康记录。确定了 2006 年至 2022 年期间使用医疗代码记录年龄≥18 岁的患者的蒸气吸入状态。我们报告了蒸气吸入代码的频率；按患者年龄、性别和种族分布；随时间记录蒸气吸入的趋势（包括中断时间序列分析）；以及患者吸烟状态的转变。
从 150114 名患者中发现了 7 种表明当前或过去蒸气吸入的医疗代码。当他们的蒸气吸入状态首次被记录时，患者的平均年龄为 50.2 岁（标准差：15.0），52.4%为女性，82.1%为白人。在被记录为当前蒸气吸入的患者中，几乎所有人（98.9%）都有其先前吸烟状态的记录：55.0%有吸烟史，38.3%戒烟，5.6%从未吸烟。在被记录为蒸气吸入之前曾吸烟的患者中，在记录蒸气吸入后一年以上，超过三分之一（34.2%）仍在吸烟，不到四分之一（23.7%）戒烟，1.7%获得“从未吸烟”状态，40.4%无吸烟状态。2019 年 9 月至 2020 年 3 月期间，“电子烟或蒸气产品使用相关肺损伤”（EVALI）爆发与当前蒸气吸入新记录的下降趋势显著相关；并且立即出现了以前的蒸气吸入的新记录显著增加，随后呈下降趋势。
很少有患者被问及蒸气吸入。大多数蒸气吸入者曾吸烟，许多人在开始蒸气吸入后戒烟。为了使电子健康记录能够提供更强的健康影响证据，我们建议提高完整性、准确性和一致性。
