Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Dermatology, Seoul National University Hospital, Seoul, Republic of Korea.
Br J Dermatol. 2024 Jul 16;191(2):225-232. doi: 10.1093/bjd/ljae130.
Smoking is a known risk factor for psoriasis; however, the impact of smoking cessation on psoriasis has seldom been evaluated.
We aimed to examine the effects of smoking cessation on the development of psoriasis vulgaris (PsV), palmoplantar pustulosis (PPP) and generalized pustular psoriasis (GPP).
Using the Korean National Health Insurance Service database, we retrospectively compiled a cohort of 5 784 973 participants without psoriasis, analysed their changes in smoking status from 2004 to 2007 and followed up new cases of psoriasis until 2021. The psoriasis risks were compared with those of sustained smokers, smoking quitters, sustained ex-smokers and never smokers using multivariate Cox proportional hazard models.
The mean age of the participants was 47.1 years (SD 13.5) and 3 092 426 (53.5%) were male. During 77 990 688 person-years, 67 364 psoriasis cases were identified. Compared with sustained smokers, smoking quitters showed a reduced risk of developing psoriasis [adjusted hazard ratio (aHR) 0.91; 95% confidence interval (CI) 0.87-0.95], specifically PsV (aHR 0.92; 95% CI 0.88-0.97) and PPP (aHR 0.71; 95% CI 0.63-0.79). The reduction in risk due to smoking cessation was more prominent in sustained ex-smokers (psoriasis: aHR 0.77, 95% CI 0.74-0.79; PsV: aHR 0.76, 95% CI 0.73-0.79; PPP: aHR 0.56, 95% CI 0.51-0.61; GPP: aHR 0.64; 95% CI 0.52-0.78). When conducting sensitivity analyses to address the potential for changes in smoking habits after 2007, the results and trends were consistent with the main findings, and a more pronounced significance was observed.
Compared with continuous smoking, smoking cessation was associated with a decreased risk of developing psoriasis. The risk-reducing effect of smoking cessation was more pronounced in those maintaining a smoke-free status. Smoking cessation and the maintenance of a smoke-free status should be encouraged to prevent the development of psoriasis and all other smoking-related diseases.
吸烟是银屑病的已知危险因素；然而，戒烟对银屑病的影响很少被评估。
我们旨在研究戒烟对寻常型银屑病（PsV）、掌跖脓疱病（PPP）和泛发性脓疱性银屑病（GPP）发展的影响。
我们使用韩国国家健康保险服务数据库，回顾性地汇编了一个无银屑病的 5784973 名参与者队列，分析了他们 2004 年至 2007 年期间的吸烟状况变化，并随访至 2021 年新确诊的银屑病病例。使用多变量 Cox 比例风险模型比较了银屑病风险与持续吸烟者、戒烟者、持续戒烟者和从不吸烟者的风险。
参与者的平均年龄为 47.1 岁（标准差 13.5），3092426 人（53.5%）为男性。在 77990688 人年期间，共发现 67364 例银屑病病例。与持续吸烟者相比，戒烟者患银屑病的风险降低（调整后的危险比[aHR]0.91；95%置信区间[CI]0.87-0.95），特别是 PsV（aHR 0.92；95%CI 0.88-0.97）和 PPP（aHR 0.71；95%CI 0.63-0.79）。戒烟导致的风险降低在持续戒烟者中更为显著（银屑病：aHR 0.77，95%CI 0.74-0.79；PsV：aHR 0.76，95%CI 0.73-0.79；PPP：aHR 0.56，95%CI 0.51-0.61；GPP：aHR 0.64；95%CI 0.52-0.78）。当进行敏感性分析以解决 2007 年后吸烟习惯变化的潜在问题时，结果和趋势与主要发现一致，且意义更为显著。
与持续吸烟相比，戒烟与患银屑病的风险降低相关。戒烟对维持无烟状态的个体的风险降低作用更为显著。应鼓励戒烟和保持无烟状态，以预防银屑病和所有其他与吸烟相关的疾病的发生。
