Time to First Cigarette, a Proxy of Nicotine Dependence, Increases the Risk of Pulmonary Impairment, Independently of Current and Lifetime Smoking Behavior
Time to First Cigarette, a Proxy of Nicotine Dependence, Increases the Risk of Pulmonary Impairment, Independently of Current and Lifetime Smoking Behavior
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DOI：
10.1093/ntr/ntv291
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发表时间：
2016-06-01
影响因子：
4.7
通讯作者：
Thapa, Sunita
中科院分区：
文献类型：
--
作者：
Selya, Arielle S.;Oancea, Sanda Cristina;Thapa, Sunita
简介：吸烟是慢性阻塞性肺疾病（COPD）的最大已知危险因素，但对第一支烟的时间（TTFC）的作用知之甚少，TTFC是尼古丁依赖（ND）的指标。本研究探讨是否每日TTFC与肺的结果，独立的吸烟behaviors.Methods：一个横截面样本的1461目前的成年吸烟者从国家健康和营养检查调查（NHANES），2007-2010年。每日TTFC与肺功能测定定义的肺功能障碍和自我报告的呼吸道症状（咳嗽，咳痰，喘息）的结果的关系进行了检查（1）在未调整的水平，（2）调整后的吸烟量和持续时间，和（3）调整后的环境暴露和人口统计学。当比较TTFC在5到30分钟之间和TTFC在30到60分钟之间以及TTFC > 60分钟时，经常发现类似的关联。早期TTFC测量的“成瘾”吸烟与肺量计测量的阻塞性肺损伤的风险显著增加以及报告咳嗽和痰症状的风险显著增加相关，即使在控制了吸烟行为和其他COPD风险因素之后。TTFC可能被证明是有价值的，在更精确地评估吸烟者的风险肺impairment.Implications：这项研究表明，吸烟清醒后不久，一个可靠的指标ND，大大增加了肺功能测定定义的肺功能障碍和自我报告的症状，独立的寿命和目前的吸烟行为的风险。这项研究增加了一小部分文献，研究与较高ND相关的健康结局，包括COPD的结局。目前的研究至少在两个方面克服了这些现有研究的重要缺点：控制其他已知的COPD风险因素，以及使用经验性的肺功能测定结果而不是自我报告的COPD结果。
Introduction: Cigarette smoking is the largest known risk factor for chronic obstructive pulmonary disease (COPD), but little is known about the role of time to first cigarette (TTFC), an indicator of nicotine dependence (ND). This study examines whether daily TTFC is associated with pulmonary outcomes, independently of smoking behavior.Methods: A cross-sectional sample of 1461 current adult smokers were drawn from the National Health and Nutrition Examination Survey (NHANES), 2007-2010. The relationships of daily TTFC with outcomes of spirometry-defined pulmonary impairment and self-reported respiratory symptoms (coughing, bringing up phlegm, and wheezing) were examined (1) at the unadjusted level, (2) after adjusting for smoking heaviness and duration, and (3) after also adjusting for environmental exposure and demographics.Results: In fully-adjusted weighted regressions, those reporting TTFC 60 minutes. Similar associations were often found when comparing TTFC between 5 to 30 minutes and TTFC between 30 to 60 minutes with TTFC > 60 minutes.Conclusions: "Addicted" smoking, as measured by earlier TTFC, is associated with a markedly increased risk of spirometry-measured obstructive pulmonary impairment, and of reporting symptoms of coughing and phlegm, even after controlling for smoking behavior and other risk factors for COPD. TTFC may prove valuable in more precisely assessing smokers' risk of pulmonary impairment.Implications: This study shows that smoking sooner after waking, a reliable indicator of ND, substantially increases the risk of spirometry-defined pulmonary impairment and self-reported symptoms, independently of lifetime and current smoking behavior. This study adds to a small body of literature examining health outcomes associated with higher ND, including outcomes of COPD. The current study overcomes important shortcomings of these existing studies in at least two ways: controlling for other known risk factors for COPD, and using empirical, spirometry-defined outcomes pulmonary function rather than self-reported COPD outcomes.