Longitudinal association of exclusive and dual use of cigarettes and cigars with asthma exacerbation among US adults: a cohort study.

IF 5.8 2区 医学 Q1 Medicine Respiratory Research Pub Date : 2024-08-10 DOI:10.1186/s12931-024-02930-y
Akash Patel, James H Buszkiewicz, Steven Cook, Douglas A Arenberg, Nancy L Fleischer
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Abstract

Background: Cigar use among adults in the United States has remained relatively stable in the past decade and occupies a growing part of the tobacco marketplace as cigarette use has declined. While studies have established the detrimental respiratory health effects of cigarette use, the effects of cigar use need further characterization. In this study, we evaluate the prospective association between cigar use, with or without cigarettes, and asthma exacerbation.

Methods: We used data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study to run generalized estimating equation models examining the association between time-varying, one-wave-lagged cigarette and cigar use and self-reported asthma exacerbation among US adults (18+). We defined our exposure as non-established (reference), former, exclusive cigarette, exclusive cigar, and dual use. We defined an asthma exacerbation event as a reported asthma attack in the past 12 months necessitating oral or injected steroid medication or asthma symptoms disrupting sleep at least once a week in the past 30 days. We adjusted for age, sex, race and ethnicity, household income, health insurance, established electronic nicotine delivery systems use, cigarette pack-years, secondhand smoke exposure, obesity, and baseline asthma exacerbation.

Results: Exclusive cigarette use (incidence rate ratio (IRR): 1.26, 95% confidence interval (CI): 1.03-1.54) and dual use (IRR: 1.41, 95% CI: 1.08-1.85) were associated with a higher rate of asthma exacerbation compared to non-established use, while former use (IRR: 1.01, 95% CI: 0.80-1.28) and exclusive cigar use (IRR: 0.70, 95% CI: 0.42-1.17) were not.

Conclusion: We found no association between exclusive cigar use and self-reported asthma exacerbation. However, exclusive cigarette use and dual cigarette and cigar use were associated with higher incidence rates of self-reported asthma exacerbation compared to non-established use. Studies should evaluate strategies to improve cigarette and cigar smoking cessation among adults with asthma who continue to smoke.

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美国成年人只吸食和双重吸食香烟和雪茄与哮喘恶化之间的纵向联系:一项队列研究。
背景:在过去的十年中,美国成年人使用雪茄的情况相对稳定,而且随着卷烟使用量的下降,雪茄在烟草市场上所占的份额也越来越大。虽然已有研究证实使用香烟会对呼吸系统健康造成有害影响,但使用雪茄的影响还需要进一步确定。在这项研究中,我们评估了使用雪茄(无论是否吸烟)与哮喘恶化之间的前瞻性关联:我们使用烟草与健康人群评估研究第 1-5 波(2013-2019 年)的数据运行广义估计方程模型,研究美国成年人(18 岁以上)中使用香烟和雪茄与自我报告的哮喘恶化之间的时变、一波滞后关系。我们将暴露定义为非既定(参考)、曾经、专门使用香烟、专门使用雪茄和双重使用。我们将哮喘恶化事件定义为在过去 12 个月中报告的哮喘发作,需要口服或注射类固醇药物,或在过去 30 天中哮喘症状扰乱睡眠至少每周一次。我们对年龄、性别、种族和民族、家庭收入、医疗保险、已使用电子尼古丁递送系统、吸烟包年、二手烟暴露、肥胖和基线哮喘恶化进行了调整:结果:完全使用香烟(发病率比(IRR):1.26,95% 置信区间:1.26,95% 置信区间:1.26结果:与不吸烟的人相比,完全吸烟(发病率比(IRR):1.26,95% 置信区间(CI):1.03-1.54)和双重吸烟(发病率比(IRR):1.41,95% 置信区间(CI):1.08-1.85)与较高的哮喘恶化率有关,而以前吸烟(发病率比(IRR):1.01,95% 置信区间(CI):0.80-1.28)和完全吸烟(发病率比(IRR):0.70,95% 置信区间(CI):0.42-1.17)与较高的哮喘恶化率无关:结论:我们发现,只吸食雪茄与自我报告的哮喘恶化之间没有关联。然而,与不吸烟者相比,只吸烟者以及吸烟和抽雪茄的双重吸烟者自我报告的哮喘恶化发生率较高。研究应评估改善继续吸烟的成年哮喘患者戒烟和戒雪茄的策略。
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来源期刊
Respiratory Research
Respiratory Research RESPIRATORY SYSTEM-
CiteScore
9.70
自引率
1.70%
发文量
314
审稿时长
4-8 weeks
期刊介绍: Respiratory Research publishes high-quality clinical and basic research, review and commentary articles on all aspects of respiratory medicine and related diseases. As the leading fully open access journal in the field, Respiratory Research provides an essential resource for pulmonologists, allergists, immunologists and other physicians, researchers, healthcare workers and medical students with worldwide dissemination of articles resulting in high visibility and generating international discussion. Topics of specific interest include asthma, chronic obstructive pulmonary disease, cystic fibrosis, genetics, infectious diseases, interstitial lung diseases, lung development, lung tumors, occupational and environmental factors, pulmonary circulation, pulmonary pharmacology and therapeutics, respiratory immunology, respiratory physiology, and sleep-related respiratory problems.
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