Passive smoking as well as active smoking increases the risk of acute stroke
Passive smoking as well as active smoking increases the risk of acute stroke
复制标题
DOI：
10.1136/tc.8.2.156
复制
发表时间：
1999-06-01
期刊：
影响因子：
5.2
通讯作者：
Beaglehole, R
中科院分区：
文献类型：
--
作者：
Bonita, R;Duncan, J;Beaglehole, R
目的：评估与环境烟草烟雾(ETS，被动吸烟)暴露相关的中风的相对风险，并使用传统的基线组(从不吸烟者)和基线组(包括终身不吸烟者和长期(10年)戒烟者)估计与当前吸烟(主动吸烟)相关的中风风险。设计和设置-新西兰奥克兰居民中基于人群的病例对照研究。研究对象来自以人群为基础的急性中风登记机构奥克兰中风研究。对照是从同一人群中测量的主要心血管危险因素的横断面调查获得的。结果-获得了521名首次急性卒中患者和1851名社区对照的信息，年龄在35-74岁。在使用Logistic回归调整了潜在混杂因素(年龄、性别、高血压、心脏病和糖尿病病史)后，非吸烟者和长期吸烟者暴露于ETS与显著增加中风风险相关(优势比(OR)=1.82；95%可信区间(95%CI)=1.34至2.49)。男性(OR=2.10；95%CI=1.33~3.32)和女性(OR=1.66；95%CI=1.07~2.57)发病风险显著。与从未吸烟者相比，吸烟者发生中风的风险增加了4倍(OR=4.14；95%CI=3.04~5.63)；当吸烟者与从未吸烟或戒烟10年以上且未接触ETS的人相比时，发生中风的风险增加(OR=6.33；95%CI=4.50~8.91)。结论：本研究是少数研究被动吸烟与急性中风风险之间关系的研究之一。我们发现男性和女性患中风的风险都显著增加。这项研究也证实了吸烟的男性和女性比不吸烟的人中风的风险更高。当那些接触过ETS的人被排除在不吸烟的参照组之外时，中风的风险进一步增加。这些发现还表明，研究吸烟的不利影响的研究将低估如果不考虑暴露于ETS的风险。
Objective-To estimate the relative risk of stroke associated with exposure to environmental tobacco smoke (ETS, passive smoking) and to estimate the risk of stroke associated with current smoking (active smoking) using the traditional baseline group (never-smokers) and a baseline group that includes lifelong nonsmokers and long-term (>10 years) ex-smokers who have not been exposed to ETS.Design and setting-Population-based case-control study in residents of Auckland, New Zealand.Subjects-Cases were obtained from the Auckland stroke study, a population-based register of acute stroke. Controls were obtained from a cross-sectional survey of major cardiovascular risk factors measured in the same population. A standard questionaire was administered to patients and controls by trained nurse interviewers.Results-Information was available for 521 patients with first-ever acute stroke and 1851 community controls aged 35-74 years. After adjusting for potential confounders (age, sex, history of hypertension, heart disease, and diabetes) using logistic regression, exposure to ETS among non-smokers and long-term ex-smokers was associated with a significantly increased risk of stroke (odds ratio (OR) = 1.82; 95% confidence interval (95% CI) = 1.34 to 2.49). The risk was significant in men (OR = 2.10; 95% CI = 1.33 to 3.32) and women (OR = 1.66; 95% CI = 1.07 to 2.57). Active smokers had a fourfold risk of stroke compared with people who reported they had never smoked cigarettes (OR = 4.14; 95% CI = 3.04 to 5.63); the risk increased when active smokers were compared with people who had never smoked or had quit smoking more than 10 years earlier and who were not exposed to ETS (OR = 6.33; 95% CI = 4.50 to 8.91).Conclusions-This study is one of the few to investigate the association between passive smoking and the risk of acute stroke. We found a significantly increased risk of stroke in men and in women. This study also confirms the higher risk of stroke in men and women who smoke cigarettes compared with non-smokers. The stroke risk increases further when those who have been exposed to ETS are excluded from the non-smoking reference group. These findings also suggest that studies investigating the adverse effects of smoking will underestimate the risk if exposure to ETS is not taken into account.