加热烟草制品使用与气道阻塞的相关性：一项单中心观察性研究，日本。
Association between heated tobacco product use and airway obstruction: a single-centre observational study, Japan.
机构信息
Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
The Tokyo Foundation for Policy Research, Minato-ku, Tokyo, Japan.
出版信息
BMJ Open Respir Res. 2024 Mar 9;11(1):e001793. doi: 10.1136/bmjresp-2023-001793.
BACKGROUND
While heated tobacco products (HTPs) may affect pulmonary function, the evidence supporting the utility of screening for HTP use in clinical settings is insufficient. We examined the association between HTP use and airway obstruction after switching from cigarettes.
METHOD
The study subjects were patients aged ≥20 years undergoing surgery from December 2021 to September 2022 who completed spirometry and reported tobacco (cigarette and HTP) use status during the preoperative assessment. Airway obstruction was defined as forced expiratory volume in 1 s to forced vital capacity ratio below the lower limit of normal. Current tobacco use was defined as past-30-day use. Multivariable Poisson regression analysis was performed to examine the associations between HTP use and airway obstruction by adjusting for demographic characteristics, lifetime cigarette smoking (pack-year) and duration of smoking cessation.
RESULTS
Overall (N=2850, 55.4% women, mean age 62.4), 4.6% and 10.7% reported current HTP use and cigarette smoking, respectively. 16.8% had airway obstruction. Airway obstruction was more common among current HTP-only users (adjusted prevalence ratio (APR)=2.32), current cigarette-only smokers (APR=2.57) and current dual users (APR=2.82) than never-tobacco users. Among current tobacco users (N=398), the prevalence of airway obstruction was not significantly different between HTP-only users and cigarette-only smokers. Among former cigarette smokers (>30-day cigarette quitters) (N=1077), current HTP users had 1.42 times the increased prevalence of airway obstruction than never-HTP users after adjusting for cigarette pack-year; a stronger association was observed when the analysis was restricted to ≥5-year cigarette quitters (N=772) (APR=1.96, vs never HTP users).
CONCLUSION
Current HTP use was associated with airway obstruction among patients with cancer who had completely switched from cigarettes even after quitting smoking for a long period. Patients should be routinely screened for HTP use and advised to quit any tobacco.
背景
虽然加热烟草制品（HTP）可能会影响肺功能，但在临床环境中筛查 HTP 使用的效用的证据还不够充分。我们研究了从香烟转为使用 HTP 后与气道阻塞的相关性。
方法
研究对象为 20 岁及以上、2021 年 12 月至 2022 年 9 月期间接受手术且在术前评估期间报告烟草（香烟和 HTP）使用情况的患者。气道阻塞定义为 1 秒用力呼气量与用力肺活量的比值低于正常下限。当前烟草使用定义为过去 30 天的使用情况。多变量泊松回归分析用于调整人口统计学特征、终生吸烟（包年）和戒烟持续时间后，检查 HTP 使用与气道阻塞之间的关联。
结果
总体而言（N=2850，55.4%女性，平均年龄 62.4 岁），分别有 4.6%和 10.7%的患者报告当前使用 HTP 和香烟。16.8%的患者有气道阻塞。与从不吸烟的患者相比，当前仅使用 HTP 的患者（调整后的患病率比（APR）=2.32）、当前仅使用香烟的吸烟者（APR=2.57）和当前同时使用两者的患者（APR=2.82），气道阻塞更为常见。在当前吸烟的患者中（N=398），仅使用 HTP 的患者和仅使用香烟的吸烟者的气道阻塞患病率没有显著差异。在过去的吸烟者（>30 天戒烟者）中（N=1077），在调整香烟包年数后，当前使用 HTP 的患者的气道阻塞患病率比从未使用 HTP 的患者增加了 1.42 倍；当分析仅限于≥5 年的戒烟者（N=772）时，这种相关性更强（APR=1.96，与从未使用 HTP 的患者相比）。
结论
即使在长时间戒烟后，癌症患者完全从香烟转为使用 HTP 也与气道阻塞有关。患者应常规筛查 HTP 使用情况并建议戒烟任何烟草。
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