背景:在过去的十年中,美国成年人的雪茄使用保持相对稳定,并且随着香烟使用的减少,在烟草市场中占据了越来越多的部分。虽然研究已经确定了吸烟对呼吸健康的有害影响,雪茄的使用效果需要进一步表征。在这项研究中,我们评估了雪茄使用之间的前瞻性关联,不管有没有香烟,和哮喘恶化。
方法:我们使用来自烟草与健康研究人口评估的Waves1-5(2013-2019)的数据来运行广义估计方程模型,检查时变,美国成年人中单波滞后的香烟和雪茄使用和自我报告的哮喘加重(18+)。我们将我们的暴露定义为非既定(参考),前者,独家香烟,独家雪茄,双重使用。我们将哮喘加重事件定义为过去12个月内报告的哮喘发作,需要口服或注射类固醇药物或哮喘症状,在过去30天内每周至少一次干扰睡眠。我们调整了年龄,性别,种族和民族,家庭收入,健康保险,已建立的电子尼古丁输送系统使用,香烟包装年,二手烟暴露,肥胖,和基线哮喘恶化。
结果:独家使用香烟(发生率比(IRR):1.26,95%置信区间(CI):1.03-1.54)和双重使用(IRR:1.41,95%CI:1.08-1.85)与未确定的使用相比,哮喘加重率更高。而以前的使用(IRR:1.01,95%CI:0.80-1.28)和独家雪茄使用(IRR:0.70,95%CI:0.42-1.17)则没有。
结论:我们发现独家使用雪茄与自我报告的哮喘恶化之间没有关联。然而,与未确定的使用相比,独家使用香烟和双重使用香烟和雪茄与自我报告的哮喘加重发生率较高相关.研究应评估策略,以改善继续吸烟的哮喘成年人的香烟和雪茄戒烟。
BACKGROUND: Cigar use among adults in the United States has remained relatively stable in the past decade and occupies a growing part of the tobacco marketplace as cigarette use has declined. While studies have established the detrimental respiratory health effects of cigarette use, the effects of cigar use need further characterization. In this study, we evaluate the prospective association between cigar use, with or without cigarettes, and asthma exacerbation.
METHODS: We used data from Waves 1-5 (2013-2019) of the Population Assessment of Tobacco and Health Study to run generalized estimating equation models examining the association between time-varying, one-wave-lagged cigarette and cigar use and self-reported asthma exacerbation among US adults (18+). We defined our exposure as non-established (reference), former, exclusive cigarette, exclusive cigar, and dual use. We defined an asthma exacerbation event as a reported asthma attack in the past 12 months necessitating oral or injected steroid medication or asthma symptoms disrupting sleep at least once a week in the past 30 days. We adjusted for age, sex, race and ethnicity, household income, health insurance, established electronic nicotine delivery systems use, cigarette pack-years, secondhand smoke exposure, obesity, and baseline asthma exacerbation.
RESULTS: Exclusive cigarette use (incidence rate ratio (IRR): 1.26, 95% confidence interval (CI): 1.03-1.54) and dual use (IRR: 1.41, 95% CI: 1.08-1.85) were associated with a higher rate of asthma exacerbation compared to non-established use, while former use (IRR: 1.01, 95% CI: 0.80-1.28) and exclusive cigar use (IRR: 0.70, 95% CI: 0.42-1.17) were not.
CONCLUSIONS: We found no association between exclusive cigar use and self-reported asthma exacerbation. However, exclusive cigarette use and dual cigarette and cigar use were associated with higher incidence rates of self-reported asthma exacerbation compared to non-established use. Studies should evaluate strategies to improve cigarette and cigar smoking cessation among adults with asthma who continue to smoke.