Childhood Cigarette Smoking and Risk of Chronic Obstructive Pulmonary Disease in Older U.S. Adults.
Childhood Cigarette Smoking and Risk of Chronic Obstructive Pulmonary Disease in Older U.S. Adults.
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儿童时期吸烟与美国老年人患慢性阻塞性肺疾病的风险。
DOI：
10.1164/rccm.202303-0476oc
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发表时间：
2023
影响因子：
24.7
通讯作者：
Paulin,LauraM
中科院分区：
文献类型：
--
作者：
Sargent,JamesD;Halenar,Michael;Steinberg,AlexanderW;Ozga,Jenny;Tang,Zhiqun;Stanton,CassandraA;Paulin,LauraM
理由：不确定儿童吸烟增加慢性阻塞性肺疾病（COPD）风险的程度与终生吸烟无关。目的：我们研究了开始定期吸烟的年龄、当前吸烟状况、吸烟史和COPD风险之间的关系。方法：在2020年全国健康访谈调查中对小于40岁的美国成年人进行横断面调查。曾经吸烟的受访者被问及何时开始定期吸烟。多变量分析评估了COPD诊断的自我报告作为开始吸烟年龄（<15年vs大于或等于15年）的函数，调整了当前吸烟、卷烟包年数和协变量。测量和主要结果：总体而言，7.1%报告他们患有COPD，从不吸烟者报告2.6%，而吸烟开始<15年和大于或等于15年分别为23.1%和11.6%。在<15岁时开始经常吸烟的人有更高的吸烟包年（中位数，分别为29和15），并且更高的吸烟强度（中位数，<15年的20支/天vs大于或等于15年的10支/天）。在多变量分析中，与晚发吸烟者相比，儿童吸烟者患COPD的相对风险为1.41（95%可信区间为1.22-1.63）。将吸烟持续时间替换为一包年混淆了当前吸烟与慢性阻塞性肺病之间的关联，但没有改变儿童吸烟的估计。在一项分层分析中，在所有当前的吸烟强度水平下，儿童吸烟的风险都较高。结论：在年龄大于或等于40岁的成年人中，五分之一的儿童吸烟者患有COPD。终生吸烟可以部分解释，但不是全部。如果重复，这表明肺部发育窗口对吸烟的脆弱性增加。
Rationale:It is not certain the extent to which childhood smoking adds chronic obstructive pulmonary disease (COPD) risk independent of lifetime cigarette exposure.Objectives:We examined the association between age started smoking cigarettes regularly, current smoking status, smoking history, and risk of COPD.Methods:Cross-sectional survey of U.S. adults ⩾40 years old in the 2020 National Health Interview Survey. Respondents who were ever cigarette smokers were asked when they began smoking regularly. Multivariable analysis assessed self-report of COPD diagnosis as a function of age started smoking (<15 yr vs. ⩾15 yr) adjusting for current smoking, cigarette pack-years, and covariates.Measurements and Main Results:Overall, 7.1% reported that they had COPD, 2.6% for never-smokers compared with 23.1% and 11.6% for smoking onset <15 and ⩾15 years, respectively. Persons who began smoking regularly at <15 years of age had higher pack-years of smoking (median, 29 vs. 15, respectively), and higher smoking intensity (median, 20 cigarettes/d for <15 yr vs. 10 cigarettes/d for ⩾15 yr for current smokers). In the multivariable analysis, the relative risk for COPD among childhood smokers was 1.41 (95% confidence interval, 1.22–1.63) compared with later-onset smokers. Substituting smoking duration for pack-years confounded the association between current smoking and COPD but did not change the childhood smoking estimate. In a stratified analysis, higher risk for childhood smoking was found at all current smoking intensity levels.Conclusions:Among adults aged ⩾40 years, one-fifth of childhood smokers have COPD. Lifetime cigarette smoking explained some but not all of the higher risk. If replicated, this suggests a lung development window of enhanced vulnerability to cigarette smoking.
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DOI：
10.1093/infdis/150.5.745
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1984
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The Journal of infectious diseases
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DOI：
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