The Effects of Smoking Cessation on the Risk of Chronic Obstructive Pulmonary Disease Exacerbations
The Effects of Smoking Cessation on the Risk of Chronic Obstructive Pulmonary Disease Exacerbations
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DOI：
10.1007/s11606-009-0907-y
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发表时间：
2009-04-01
影响因子：
5.7
通讯作者：
Bradley, Katharine A.
中科院分区：
文献类型：
--
作者：
Au, David H.;Bryson, Christopher L.;Bradley, Katharine A.
戒烟已被证明可以降低轻度至中度慢性阻塞性肺疾病（COPD）患者的肺功能丧失率和死亡率。关于戒烟对COPD急性加重风险的影响缺乏证据，我们试图检查吸烟状况和戒烟持续时间是否与COPD急性加重风险降低相关，我们通过自我报告评估了当前吸烟状况和戒烟持续时间。我们的主要结局是住院或门诊COPD加重。我们使用考克斯回归来估计与吸烟状态和戒烟持续时间相关的COPD恶化的风险。我们对23，971名退伍军人进行了队列研究，这些退伍军人是当前和过去的吸烟者，并在美国退伍军人事务部（VA）的七个初级保健诊所之一就诊。与当前吸烟者相比，在校正年龄、合并症、COPD严重程度标志物和社会经济状况后，既往吸烟者COPD加重的风险显著降低（校正HR 0.78，95% CI 0.75-0.87）。降低风险的程度取决于戒烟的持续时间（调整后HR：戒烟< 1年，1.04; 95% CI 0.87-1.26; 1-5年0.93，95% CI 0.79-1.08; 5-10年0.84，95% CI 0.70-1.00; a千分之0.65，95%CI 0.58-0.74;线性趋势< 0.001）。戒烟与COPD恶化风险降低相关，所述降低取决于戒烟持续时间。
Smoking cessation has been demonstrated to reduce the rate of loss of lung function and mortality among patients with mild to moderate chronic obstructive pulmonary disease (COPD). There is a paucity of evidence about the effects of smoking cessation on the risk of COPD exacerbations.We sought to examine whether smoking status and the duration of abstinence from tobacco smoke is associated with a decreased risk of COPD exacerbations.We assessed current smoking status and duration of smoking abstinence by self-report. Our primary outcome was either an inpatient or outpatient COPD exacerbation. We used Cox regression to estimate the risk of COPD exacerbation associated with smoking status and duration of smoking cessation.We performed a cohort study of 23,971 veterans who were current and past smokers and had been seen in one of seven Department of Veterans Affairs (VA) primary care clinics throughout the US.In comparison to current smokers, ex-smokers had a significantly reduced risk of COPD exacerbation after adjusting for age, comorbidity, markers of COPD severity and socio-economic status (adjusted HR 0.78, 95% CI 0.75-0.87). The magnitude of the reduced risk was dependent on the duration of smoking abstinence (adjusted HR: quit < 1 year, 1.04; 95% CI 0.87-1.26; 1-5 years 0.93, 95% CI 0.79-1.08; 5-10 years 0.84, 95% CI 0.70-1.00; a parts per thousand yen10 years 0.65, 95% CI 0.58-0.74; linear trend < 0.001).Smoking cessation is associated with a reduced risk of COPD exacerbations, and the described reduction is dependent upon the duration of abstinence.