Effect of cigar smoking on the risk of cardiovascular disease, chronic obstructive pulmonary disease, and cancer in men
Effect of cigar smoking on the risk of cardiovascular disease, chronic obstructive pulmonary disease, and cancer in men
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DOI：
10.1056/nejm199906103402301
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发表时间：
1999-06-10
影响因子：
158.5
通讯作者：
Friedman, GD
中科院分区：
文献类型：
--
作者：
Iribarren, C;Tekawa, IS;Friedman, GD
背景自1993年以来，美国雪茄的销售量一直在增加。吸烟是某些癌症和慢性阻塞性肺疾病(COPD)的已知危险因素。然而，与吸烟与心血管疾病之间的关系不同，吸烟雪茄与心血管疾病之间的关联尚未明确确立。方法我们对17774名年龄在30岁至85岁之间的男性进行了队列研究，这些男性在1964年至1973年期间参加了Kaiser Permanente健康计划，他们报告说他们从未吸烟，目前也没有吸烟斗。从1971年到1995年底，对那些抽雪茄的人(1546名男性)和不抽雪茄的人(16228人)进行了跟踪调查，从1971年到1995年底，他们第一次因重大心血管疾病或COPD住院或死亡，直到1996年底被诊断为癌症。结果在多因素分析中，抽雪茄的人比不吸烟的人患冠心病的风险更高(相对风险为1.27；95%可信区间为1.12至1.45)，COPD(相对风险为1.45；上呼吸道癌症(相对风险为2.02；95%可信区间为1.01至4.06)和肺癌(相对风险为2.14；95%可信区间为1.12至4.11)，并有剂量反应效应的证据。吸烟和饮酒对口咽癌和上呼吸道癌症的风险有协同作用。结论经常吸烟独立于其他危险因素，可增加冠心病、慢性阻塞性肺病、上呼吸道和肺癌的风险。(N Engl J Med 1999；340：1773-80)(C)1999年，马萨诸塞州医学会。
Background The sale of cigars in the United States has been increasing since 1993. Cigar smoking is a known risk factor for certain cancers and for chronic obstructive pulmonary disease (COPD). However, unlike the relation between cigarette smoking and cardiovascular disease, the association between cigar smoking and cardiovascular disease has not been clearly established.Methods We performed a cohort study among 17,774 men 30 to 85 years of age at base line (from 1964 through 1973) who were enrolled in the Kaiser Permanente health plan and who reported that they had never smoked cigarettes and did not currently smoke a pipe. Those who smoked cigars (1546 men) and those who did not (16,228) were followed from 1971 through the end of 1995 for a first hospitalization for or death from a major cardiovascular disease or COPD, and through the end of 1996 for a diagnosis of cancer.Results In multivariate analyses, cigar smokers, as compared with nonsmokers, were at higher risk for coronary heart disease (relative risk, 1.27; 95 percent confidence interval, 1.12 to 1.45), COPD (relative risk, 1.45; 95 percent confidence interval, 1.10 to 1.91), and cancers of the upper aerodigestive tract (relative risk, 2.02; 95 percent confidence interval, 1.01 to 4.06) and lung (relative risk, 2.14; 95 percent confidence interval, 1.12 to 4.11), with evidence of dose-response effects. There appeared to be a synergistic relation between cigar smoking and alcohol consumption with respect to the risk of oropharyngeal cancers and cancers of the upper aerodigestive tract.Conclusions Independently of other risk factors, regular cigar smoking can increase the risk of coronary heart disease, COPD, and cancers of the upper aerodigestive tract and lung. (N Engl J Med 1999;340: 1773-80.) (C) 1999, Massachusetts Medical Society.