Respiratory health and cigar and pipe use in the NHLBI Pooled Cohorts Study

NHLBI 联合队列研究中的呼吸系统健康以及雪茄和烟斗的使用

• 批准号: 10224337
• 负责人: Elizabeth Oelsner
• 金额: $ 20.25万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-08-01 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10224337
• 关键词: Address; Adult; American Indians; Asians; Asthma; Biological Markers; CYP1A1 gene; Cause of Death; Cessation of life; Chronic; Chronic Obstructive Airway Disease; Cigar; Cigar Smoking; Cigarette; Cigarette Smoker; Clinical; Cohort Studies; Consumption; Data; Data Pooling; Decision Making; Ethnic Origin; Event; General Population; Gold; Health; Health Campaign; Hispanics; Hospitalization; Interview; Lung diseases; Measures; National Heart, Lung, and Blood Institute; Outcome; Patient Self-Report; Pattern; Persons; Phenotype; Physiological; Poison; Public Health; Pulmonary Function Test/Forced Expiratory Volume 1; Questionnaires; Race; Relative Risks; Research; Risk; Risk Factors; Sampling; Smoker; Smoking Status; Socioeconomic Status; Spirometry; Standardization; Testing; Time; Tobacco use; United States; Woman; Work; airway obstruction; base; cigarette smoke; cigarette smoking; cigarette user; clinically significant; cohort; combustible cigarette; data harmonization; disability-adjusted life years; electronic cigarette user; environmental tobacco smoke exposure; ethnic minority population; experience; follow-up; improved; men; mortality; multi-ethnic; pipe smoking; population based; preventable death; pulmonary function; pulmonary function decline; respiratory; respiratory health; sex; tobacco exposure; tobacco products; years of life lost

Summary/Abstract Chronic lower respiratory disease (CLRD), which includes chronic obstructive pulmonary disease (COPD) and asthma, is now the third leading cause of death globally. COPD, which is defined by airflow obstruction on spirometry, is a rising cause of years of life lost and disability-adjusted life years in the United States (US). Cigarette smoking, which accelerates lung function decline, is the major risk factor for CLRD. Noncigarette tobacco use, including cigars and pipes, is frequently perceived as low risk compared to cigarettes; however, concentrations of certain toxic chemicals from cigar and pipe smoking are comparable to – and, in some instances, higher than – those from cigarette smoking. This application will test if, like cigarette use, noncigarette tobacco use is associated with accelerated lung function decline and incident clinical CLRD events. We will test these hypotheses in the NHLBI Pooled Cohorts Study, which has harmonized and pooled data from 9 US general population-based cohorts that collected lung function data in 65,251 American Indian, Asian, Black, Hispanic and White adult men and women. Our investigative group has rigorously quality- controlled lung function measures across the cohorts using contemporary standards, yielding 105,696 valid spirometry exams. We have also developed and validated definitions for incident asthma- and COPD-related hospitalizations and deaths, of which there are presently >3,900 events over >340,000 person-years of follow- up. In Aim 1, we will harmonize cigar and pipe exposures across cohorts. These exposures were ascertained from standardized questionnaires and will be systematically evaluated, quality-controlled, and harmonized using the approach we have already successfully applied for cigarette tobacco exposures. We will use the harmonized data to classify our primary exposure, exclusive cigar/pipe use, defined as ever-use of cigar and/or pipe in lifelong never-cigarette smokers. We will also classify current cigar/pipe use, cumulative cigar/pipe exposure (cigar and pipe years), and current cigar/pipe intensity. In Aim 2, we will test associations between exclusive cigar/pipe use and longitudinal lung function, including decline in FEV1, FVC, and FEV1/FVC, as well as with incident airflow obstruction. In Aim 3, we will test associations with CLRD events. The proposed work will inform our understanding of the relative risks of cigar use and pipe use versus conventional cigarette use and establish the physiologic and clinical significance of cigar/pipe use with respect to chronic lower respiratory disease. These findings, which will be based upon gold standard phenotyping from a large US general population-based sample, will be suitable to inform regulatory decisions regarding cigar and pipe tobacco products.

摘要/摘要 慢性下呼吸道疾病（CLRD），包括慢性阻塞性肺疾病 慢性阻塞性肺病（COPD）和哮喘，现在是全球第三大死亡原因。COPD，其定义为气流 在美国，肺功能障碍是导致生命年损失和残疾调整生命年的一个上升的原因。 美国。吸烟加速肺功能下降，是CLRD的主要危险因素。 非卷烟烟草使用，包括雪茄和烟斗，通常被认为是低风险的， 香烟;然而，雪茄和烟斗吸烟的某些有毒化学物质的浓度与 - 在某些情况下，比吸烟更高。这个应用程序将测试，如果像香烟 非香烟烟草使用与加速肺功能下降和临床CLRD事件相关 事件 我们将在NHLBI合并队列研究中检验这些假设，该研究已协调并合并了 来自9个美国一般人群队列的数据，收集了65，251名美国印第安人的肺功能数据， 亚裔、黑人、西班牙裔和白色成年男女。我们的调查组有严格的质量- 使用当代标准对所有队列的肺功能进行了控制性测量， 肺量测定检查。我们还开发并验证了哮喘和COPD相关事件的定义 住院和死亡，其中目前有> 3，900起事件超过> 340，000人-年的随访- 起来 在目标1中，我们将协调各队列的雪茄和烟斗暴露。这些暴露是 从标准化问卷中确定，并将进行系统评估，质量控制， 使用我们已经成功应用于香烟烟草暴露的方法进行协调。我们将 使用协调数据对我们的主要暴露进行分类，专门使用雪茄/烟斗，定义为经常使用 雪茄和/或烟斗在终身不吸烟者。我们还将对当前的雪茄/烟斗使用情况进行分类， 雪茄/烟斗暴露（雪茄和烟斗年）和当前雪茄/烟斗强度。在目标2中，我们将测试关联 完全使用雪茄/烟斗与纵向肺功能之间的关系，包括FEV 1、FVC和 FEV 1/FVC，以及伴随气流阻塞。在目标3中，我们将测试与CLRD事件的关联。 这项拟议的工作将使我们了解使用雪茄和烟斗的相对风险， 传统香烟的使用，并建立雪茄/烟斗使用的生理和临床意义， 慢性下呼吸道疾病这些发现，这将是基于金标准表型，从 一个大的美国一般人群为基础的样本，将适合告知有关雪茄和 烟斗烟草产品。