Physiopathology and Epidemiology Cerebro-Cardiovascular, PEC2, EA 7460 UFR Health Sciences, University of Burgundy and Franche Comté, Dijon, France; University Paris Cité, AP-HP.Center, Outpatient Addictology Center, Paris, France; Groupement d'Intérêt Scientifique du Réseau Français d'Excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France.
Physiopathology and Epidemiology Cerebro-Cardiovascular, PEC2, EA 7460 UFR Health Sciences, University of Burgundy and Franche Comté, Dijon, France; Groupement d'Intérêt Scientifique du Réseau Français d'Excellence de Recherche sur Tabac, nicotine et produit connexes (GIS REfer Tab), Paris, France; Cardiology Department, Dijon University Hospital, Dijon, France.
Arch Cardiovasc Dis. 2024 Aug-Sep;117(8-9):480-489. doi: 10.1016/j.acvd.2024.06.001. Epub 2024 Jul 15.
Smoking is a major risk factor for cardiovascular diseases (CVD), in particular in women, but smoking cessation (SC) reduces or even cancels the risk for both sexes. Using a nationwide SC services database, we aimed to determine the predictive factors of SC in men and women smokers with CV risk factors (CVRF) or CVD. A retrospective study from the French CDTnet database was conducted. Inclusion criteria were age ≥18years, and≥1 CVRF (Body Mass Index ≥25kg/m, hypertension, diabetes, hypercholesterolemia) or CVD (myocardial infarction (MI) or angina pectoris, stroke, peripheral arterial disease [PAD]). Self-reported smoking abstinence (≥28 consecutive days) was confirmed by exhaled carbon monoxide<10ppm. Logistic regression analysis assessed the association between SC and sociodemographic, medical characteristics, and smoking profile. Among the 36,864 smokers at high CV risk, abstinence rate was slightly lower in women than in men, (52.6% [n=8,102] vs 55.0% [n=11,848], P<0.001). For both sexes, factors associated with the lowest abstinence rates were diabetes, respiratory and psychiatric diseases, anxiolytic/antidepressant use, and cannabis consumption. In women, the factors associated with smoking abstinence were suffering from MI or angina and taking contraceptive pill and the factors associated with persistent smoking were alcohol disorder and high cigarette consumption. In men, there was a positive relationship between overweight and abstinence while being dual users of cigarettes and electronic cigarettes at first visit, having tobacco-related diseases (cancer and PAD) and taking opioid substitution treatment were associated with persistent smoking. Finally, in both sexes, the factors associated with abstinence were: age≥65years, having a diploma, being employed, self-referred or encouraged by entourage, ≥1 previous quit attempt, ≤20 cigarettes per day consumption, benefiting from SC medication prescription and ≥4 follow-up visits. In conclusion, our results suggest the relevance of SC intensive management in smokers at high CV risk, based on sociodemographic, medical, and smoking behaviour characteristics, as well as a gender-specific SC approach.
吸烟是心血管疾病（CVD）的主要危险因素，尤其是在女性中，但戒烟（SC）可降低甚至消除两性的风险。我们使用全国性的 SC 服务数据库，旨在确定有心血管危险因素（CVRF）或 CVD 的男性和女性吸烟者戒烟的预测因素。这是一项来自法国 CDTnet 数据库的回顾性研究。纳入标准为年龄≥18 岁，并且有≥1 个 CVRF（身体质量指数≥25kg/m2、高血压、糖尿病、高胆固醇血症）或 CVD（心肌梗死（MI）或心绞痛、中风、外周动脉疾病[PAD]）。自我报告的吸烟戒断（≥28 天连续无吸烟）通过呼出的一氧化碳<10ppm 得到确认。逻辑回归分析评估了 SC 与社会人口统计学、医学特征和吸烟状况之间的关联。在 36864 名高心血管风险的吸烟者中，女性的戒烟率略低于男性，（52.6%[n=8102] vs 55.0%[n=11848]，P<0.001）。对于两性，与最低戒烟率相关的因素是糖尿病、呼吸和精神疾病、使用抗焦虑/抗抑郁药和大麻消费。在女性中，与吸烟戒断相关的因素是患有 MI 或心绞痛和服用避孕药，与持续吸烟相关的因素是酒精障碍和高香烟消费。在男性中，超重与戒烟呈正相关，而首次就诊时同时使用香烟和电子烟、有烟草相关疾病（癌症和 PAD）和接受阿片类药物替代治疗与持续吸烟相关。最后，在两性中，与戒烟相关的因素是：年龄≥65 岁、有文凭、就业、自我推荐或被周围人鼓励、≥1 次戒烟尝试、每日吸烟≤20 支、受益于 SC 药物处方和≥4 次随访。总之，我们的结果表明，基于社会人口统计学、医学和吸烟行为特征，以及针对两性的 SC 方法，对高心血管风险的吸烟者进行 SC 强化管理是合理的。
