COVID-19, smoking and inequalities: a study of 53 002 adults in the UK
COVID-19, smoking and inequalities: a study of 53 002 adults in the UK
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DOI：
10.1136/tobaccocontrol-2020-055933
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发表时间：
2021-12-01
期刊：
影响因子：
5.2
通讯作者：
Fancourt, Daisy
中科院分区：
文献类型：
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作者：
Jackson, Sarah E.;Brown, Jamie;Fancourt, Daisy
背景：这项研究旨在检查吸烟与新冠肺炎相关结果之间的关联，考虑到不平等的影响，并调整潜在的混杂变量。方法横断面数据来自英国一项在线成人研究(n=53002)。主要观察指标为确诊和疑似新冠肺炎、担心感染新冠肺炎或患重病、坚持防护行为。协变量包括年龄、性别、种族、教育程度(16岁后学历：是/否)、关键工人身份和共病健康状况。结果与从不吸烟者(0.26%(95%CI)0.21%~0.33%)相比，既往吸烟者新冠肺炎确诊患病率(0.56%(0.41%~0.75%))高于不吸烟者(0.19%(0.13%~0.28%))。调整前(当前：OR=2.14(1.49-3.08)；戒烟者：OR=0.73(0.47-1.14))与调整后(当前：OR=1.79(1.22-2.62)；戒烟者：OR=0.85(0.54-1.33))的关联性相似。对于目前的吸烟者，这一比例受到社会经济状况的影响，只有那些没有16岁后学历的吸烟者才有更高的吸烟率(OR=3.53(2.04-6.10))。在纳入疑似病例后，现在吸烟者(11.2%(10.6%~11.9%)，OR=1.11(1.03~1.20))和戒烟者(10.9%(10.4%~11.5%)，OR=1.07(1.01~1.15))的患病率高于从不吸烟者(10.2%(9.9%~10.6%))，但仅在调整后戒烟者(OR=1.21(1.13~1.29))。现吸烟者和既往吸烟者报告因新冠肺炎患重病而承受重大压力的几率高于从不吸烟者(当前：OR=1.34(1.27-1.43)；既往吸烟者：OR=1.22(1.16-1.28))。预防新冠肺炎传播的建议的依从性很高(96.3%(96.1%比96.4%))，但现在吸烟者的忠诚度低于从不吸烟者(OR=0.70(0.62~0.78))。结论在人群样本中，当前吸烟与自我报告的确诊新冠肺炎感染独立相关。存在社会经济差异，这种联系只在没有16岁后资格的人中才明显。吸烟者报告说，尽管他们比不吸烟者更担心感染新冠肺炎或患重病，但他们对指南的遵守程度较低。
Background This study aimed to examine associations between smoking and COVID-19 relevant outcomes, taking into account the influence of inequalities and adjusting for potential confounding variables. Methods Cross-sectional data were used from an online study of adults in the UK (n=53 002). Main outcome measures were confirmed and suspected COVID-19, worry about catching or becoming seriously ill from COVID-19 and adherence to protective behaviours. Covariates included age, sex, ethnicity, education (post-16 qualifications: yes/no), key worker status and comorbid health conditions. Results Compared with never smokers (0.26% (95% CI 0.21% to 0.33%)), prevalence of confirmed COVID-19 was higher among current (0.56% (0.41% to 0.75%)) but not ex-smokers (0.19% (0.13% to 0.28%)). Associations were similar before (current: OR=2.14 (1.49-3.08); ex-smokers: OR=0.73 (0.47-1.14)) and after (current: OR=1.79 (1.22-2.62); ex-smokers: OR=0.85 (0.54-1.33)) adjustment. For current smokers, this was moderated by socio-economic position, with higher rates only seen in those without post-16 qualifications (OR=3.53 (2.04-6.10)). After including suspected cases, prevalence was higher among current smokers (11.2% (10.6% to 11.9%), OR=1.11 (1.03-1.20)) and ex-smokers (10.9% (10.4% to 11.5%), OR=1.07 (1.01-1.15)) than never smokers (10.2% (9.9% to 10.6%)), but remained higher only among ex-smokers after adjustment (OR=1.21 (1.13-1.29)). Current and ex-smokers had higher odds than never smokers of reporting significant stress about becoming seriously ill from COVID-19 (current: OR=1.34 (1.27-1.43); ex-smokers: OR=1.22 (1.16-1.28)). Adherence to recommendations to prevent spread of COVID-19 was high (96.3% (96.1% to 96.4%)), but lower among current than never smokers (OR=0.70 (0.62-0.78)). Conclusions In a population sample, current smoking was independently associated with self-reported confirmed COVID-19 infection. There were socio-economic disparities, with the association only apparent among those without post-16 qualifications. Smokers reported lower adherence to guidelines despite being more worried than non-smokers about catching or becoming seriously ill from COVID-19.