黑人女性健康研究中主动和被动吸烟与哮喘发病率间的相关性
2015/01/21
摘要
研究原理:目前关于主动和被动吸烟与成人首发哮喘患者关联性的证据是不一致的,同时存在正相关和负相关的报道。先前大部分主动吸烟的研究并没有考虑被动吸烟的暴露,而这可能引起结果偏倚。
研究目的:旨在评估黑人女性健康研究中主动吸烟和被动吸烟与成人首发哮喘发病率间的独立相关性关系。该研究是自1995年开始,在美国黑人女性中每两年进行一次调查问卷的前瞻性队列研究。
研究方法:在基线时和所有随访时更新主动吸烟者的状况调查问卷。被动吸烟者在1997年明确暴露的时间:儿童期、青少年期和成人期。哮喘病例包括医生诊断为哮喘的女性患者且反复应用抗哮喘治疗的药物。采用COX回归模型计算前期和当前吸烟多变量危险度(HR)和95%置信区间(CI)。从未主动和被动吸烟的人群作为非吸烟者中的被动吸烟者的对照组。
方法及主要结果:在1995至2011年,共随访46183例患者,其中1523例曾有过哮喘发作。前期主动吸烟、当前主动吸烟和被动吸烟的多变量HR与从未主动/被动吸烟相比分别为1.36 (95% CI 1.11-1.67),1.43 (95% CI 1.15-1.77), 1.21 (95% CI 1.00-1.45)。
结论:在本项16年随访的临床大样本研究中,主动吸烟增加了成人首发的哮喘的发病率,被动吸烟与非吸烟者相比的哮喘发生风险增加。尽量减少二手烟暴露对成年首发哮喘的发病率有一定的获益。
(苏欣 审校)
Am J Respir Crit Care Med. 2014 Nov 11. [Epub ahead of print]
Active and Passive Smoking and the Incidence of Asthma in the Black Women's Health Study.
Coogan PF1, Castro-Webb N, Yu J, O'Connor GT, Palmer JR, Rosenberg L.
ABSTRACT
RATIONALE:Evidence linking active or passive smoking to the incidence of adult-onset asthma is inconsistent, with both positive and inverse associations being reported. Most previous studies of active smoking have not accounted for passive smoke exposure, which may have introduced bias.
OBJECTIVES:To assess the separate associations of active and passive smoking to the incidence of adult-onset asthma in the Black Women's Health Study, a prospective cohort of US black women followed since 1995 with mailed biennial questionnaires. METHODS:Active smoking status was reported at baseline and updated on all follow-up questionnaires. Passive smoke exposure during childhood, adolescence, and adulthood was ascertained in 1997. Asthma cases comprised women who reported doctor-diagnosed asthma with concurrent asthma medication use. Cox regression models were used to derive multivariable hazard ratios (HR) and 95% confidence intervals (CI) for former and current smoking, and for passive smoking among nonsmokers, compared to never active or passive smokers.
MEASUREMENTS AND MAIN RESULTS:Among 46,182 participants followed from 1995 to 2011, 1523 reported incident asthma. The multivariable HRs for former active smoking, current active smoking, and passive smoking only were, respectively, 1.36 (95% CI 1.11-1.67), 1.43 (95% CI 1.15-1.77), and 1.21 (95% CI 1.00-1.45), compared to never active/passive smoking.
CONCLUSIONS:In this large population with 16 years of follow-up, active smoking increased the incidence of adult-onset asthma, and passive smoke exposure increased the risk among nonsmokers.Continued efforts to reduce exposure to tobacco smoke may have a beneficial effect on the incidence of adult-onset asthma.
Am J Respir Crit Care Med. 2014 Nov 11. [Epub ahead of print]
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空气致敏原类型预测学龄前特应性皮炎患儿发生哮喘风险的研究
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寒潮与哮喘患者住院率的相关性:美国,纽约,1991-2006