淮河流域男性居民戒烟与呼吸道慢性病关系的研究

doi:10.19983/j.issn.2096-8493.20220036

结核与肺部疾病杂志 ›› 2022, Vol. 3 ›› Issue (4): 261-268.doi: 10.19983/j.issn.2096-8493.20220036

淮河流域男性居民戒烟与呼吸道慢性病关系的研究

徐晓程¹^,², 张晗¹^,³, 邹天森¹^,³, 吕占禄¹^,³, 郭凌川¹^,³, 罗斌²(), 张金良¹^,³()

1.中国环境科学研究院环境基准与风险评估国家重点实验室,北京 100012
2.兰州大学公共卫生学院劳动卫生与环境卫生研究所,兰州 730000
3.中国环境科学研究院环境健康风险评估与研究中心,北京 100012

收稿日期:2022-03-09 出版日期:2022-08-20 发布日期:2022-08-16
通信作者: 罗斌,张金良 E-mail:luob@lzu.edu.cn;jinliangzhg@263.net
基金资助:
环境基准与风险评估国家重点实验室专项经费(22060204005)

Effects of smoking cessation on respiratory health and related chronic diseases among male residents in the Huaihe River Basin

Xu Xiaocheng¹^,², Zhang Han¹^,³, Zou Tiansen¹^,³, Lyu Zhanlu¹^,³, Guo Lingchuan¹^,³, Luo Bin²(), Zhang Jinliang¹^,³()

1. State Key Lab of Environmental Criteria and Risk Assessment,Chinese Research Academy of Environmental Sciences,Beijing 100012,China
2. Institute of Occupational Health and Environmental Health, School of Public Health, Lanzhou University, Lanzhou 730000, China
3. Center for Environmental Health Risk Assessment and Research, Chinese Research Academy of Environmental Sciences, Beijing 100012

Received:2022-03-09 Online:2022-08-20 Published:2022-08-16
Contact: Luo Bin,Zhang Jinliang E-mail:luob@lzu.edu.cn;jinliangzhg@263.net
Supported by:
Special Funds for State Key Laboratory of Environmental Criteria and Risk Assessment(22060204005)

摘要/Abstract

摘要：

目的: 通过淮河流域7个县(区)的调查分析了解农村男性居民呼吸系统症状及慢性病与戒烟行为的关系,为农村地区控烟工作和健康促进提供科学依据。方法:2015年11月至2018年10月在淮河流域7个县(区)采用目的抽样抽取乡镇和自然村,机械随机抽取20~70岁当地居民,由统一培训的调查员使用自主设计的问卷进行入户调查。选择1583名男性居民为研究对象,采用logistic回归模型分析呼吸系统症状及慢性病与吸烟、戒烟行为的关系。结果:调查地区男性居民吸烟率为49.3%(781/1583),戒烟率为26.3%(278/1059)。logistic多因素分析显示,戒烟者报告咳嗽的发生风险显著低于现在吸烟者(OR=0.62,95%CI:0.43~0.89),非因病戒烟者报告咳嗽(OR=0.51,95%CI:0.32~0.83)、慢性咳嗽(OR=0.20,95%CI:0.06~0.63)、咳痰(OR=0.54,95%CI:0.34~0.87)的发生风险显著低于现在吸烟者。累计吸烟≥30年的戒烟者报告慢性咳痰(OR=3.11,95%CI:1.03~9.40)和喘息(OR=5.73,95%CI:2.05~16.04)的发生风险显著高于累计吸烟<30年者;戒烟≥3年者报告咳嗽(OR=0.41,95%CI:0.20~0.81)和气短(OR=0.58,95%CI:0.37~1.00)的发生风险显著低于戒烟<3年者。结论:非因病戒烟可以明显降低调查地区男性吸烟居民呼吸系统症状及慢性病的患病风险,累计吸烟时间越短、戒烟时间越长戒烟效益越明显。

关键词: 戒烟, 体征和症状, 呼吸系统, 呼吸道疾病, 淮河流域

Abstract:

Objective: To understand the effects of smoking cessation on respiratory symptoms and chronic respiratory diseases among rural male residents in 7 counties of the Huaihe River Basin, which might provide scientific evidence for tobacco control and health promotion in rural China. Methods: From November 2015 to October 2018, participants aged 20-70 from 7 counties of Huaihe river basin were selected with purposive sampling and household interview for every participant was completed using self-designed questionnaire by uniformly trained investigators. Totally 1583 male participants were included. Logistic regression model was used to analyze the effects of smoking or smoking cessation on respiratory symptoms and chronic respiratory diseases. Results: The smoking rate was 49.3% (781/1583), and the smoking cessation rate was 26.3% (278/1059). Compared with current smokers, ex-smokers showed a lower risk of cough (OR=0.62, 95%CI: 0.43-0.89). The ex-smokers who quit smoking for non-health reasons had lower risks of cough (OR=0.51, 95%CI: 0.32-0.83), chronic cough (OR=0.20, 95%CI: 0.06-0.63) and expectoration (OR=0.54, 95%CI: 0.34-0.87) than those current smokers. For those ex-smokers who had been smoking ≥30 years, the risks of chronic expectoration (OR=3.11, 95%CI: 1.03-9.40) and wheezing (OR=5.73, 95%CI: 2.05-16.04) were significantly higher than those who had been smoking <30 years. Meanwhile, the risks of cough (OR=0.41, 95%CI: 0.20-0.81) and shortness of breath (OR=0.58, 95%CI: 0.37-1.00) for the ex-smokers who had quit smoking ≥3 years were significantly lower than those who had quit <3 years. Conclusion: Smoking cessation for non-health reasons was related to decreased risks of respiratory symptoms and chronic respiratory diseases for male smokers in rural Huaihe River Basin. The shorter the cumulative smoking year, the longer the smoking cessation period, the more obvious health benefits will be gained by smoking cessation.

Key words: Smoking cessation, Signs and symptoms, respiratory, Respiratory tract diseases, Huaihe River Basin

中图分类号:

R163

徐晓程, 张晗, 邹天森, 吕占禄, 郭凌川, 罗斌, 张金良. 淮河流域男性居民戒烟与呼吸道慢性病关系的研究[J]. 结核与肺部疾病杂志, 2022, 3(4): 261-268. doi: 10.19983/j.issn.2096-8493.20220036

Xu Xiaocheng, Zhang Han, Zou Tiansen, Lyu Zhanlu, Guo Lingchuan, Luo Bin, Zhang Jinliang. Effects of smoking cessation on respiratory health and related chronic diseases among male residents in the Huaihe River Basin[J]. Journal of Tuberculosis and Lung Disease, 2022, 3(4): 261-268. doi: 10.19983/j.issn.2096-8493.20220036

图/表 5

表1

表2

不同呼吸系统症状及慢性病在不同亚组及不同吸烟状况中的报告情况

特征	咳嗽	慢性咳嗽	咳痰	慢性咳痰	喘息	气短	哮喘/慢支
年龄
<60岁	146(16.2)	48(5.3)	130(14.4)	52(5.8)	56(6.2)	154(17.1)	38(4.2)
≥60岁	145(21.2)	56(8.2)	147(21.5)	70(10.2)	81(11.9)	163(23.9)	63(9.2)
χ²值	6.490	5.196	13.476	10.914	15.609	11.061	16.264
P值	0.011	0.023	<0.001	0.001	<0.001	0.001	<0.001
文化程度
初中及以下	220(19.5)	82(7.3)	204(18.1)	96(8.5)	109(9.7)	238(21.1)	78(6.9)
初中以上	71(15.6)	22(4.8)	73(16.0)	26(5.7)	28(6.1)	79(17.3)	23(5.0)
χ²值	3.377	3.178	0.985	3.620	5.121	2.917	1.915
P值	0.066	0.075	0.321	0.057	0.024	0.088	0.166
特征	咳嗽	慢性咳嗽	咳痰	慢性咳痰	喘息	气短	哮喘/慢支
职业
务农	195(18.3)	77(7.2)	184(17.3)	87(8.2)	104(9.8)	229(21.5)	68(6.4)
非务农	96(18.6)	27(5.2)	93(18.0)	35(6.8)	33(6.4)	88(17.0)	33(6.4)
χ²值	0.018	2.271	0.128	0.948	5.011	4.326	0.000
P值	0.894	0.132	0.721	0.330	0.025	0.038	0.998
婚姻
未婚	8(15.7)	5(9.8)	7(13.7)	4(7.8)	4(7.8)	9(17.6)	3(5.9)
已婚	267(18.5)	95(6.6)	245(16.9)	109(7.5)	124(8.6)	293(20.3)	93(6.4)
丧偶/离婚	16(8.9)	4(4.7)	25(29.1)	9(10.5)	9(10.5)	15(17.4)	5(5.8)
χ²值	0.256	1.385	8.788	0.979	0.411	0.589	0.074
P值	0.880	0.500	0.012	0.613	0.814	0.745	0.964
年收入
<2万元	133(20.2)	49(7.4)	124(18.8)	57(8.6)	69(10.5)	152(23.1)	50(7.6)
≥2万元	158(17.1)	55(6.0)	153(16.6)	65(7.0)	68(7.4)	165(17.9)	51(5.5)
χ²值	2.436	1.378	1.358	1.410	4.710	6.515	2.753
P值	0.119	0.240	0.244	0.235	0.030	0.011	0.097
饮酒
否	147(16.3)	53(5.9)	139(15.4)	59(6.6)	77(8.6)	175(19.4)	54(6.0)
是	144(21.1)	51(7.5)	138(20.2)	63(9.2)	60(8.8)	142(20.8)	47(6.9)
χ²值	5.840	1.576	6.096	3.887	0.026	0.439	0.505
P值	0.016	0.209	0.014	0.049	0.872	0.507	0.477
吸烟状况
从不吸烟	52(9.9)	13(2.5)	36(6.9)	19(3.6)	23(4.4)	71(13.5)	18(3.4)
现在吸烟	191(24.5)	71(9.1)	187(23.9)	77(9.9)	79(10.1)	163(20.9)	53(6.8)
戒烟	48(17.3)	20(7.2)	54(19.4)	26(9.4)	35(12.6)	83(29.9)	30(10.8)
χ²值	44.421	22.536	64.188	18.413	19.612	30.845	16.881
P值	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001	<0.001
戒烟原因
因病	26(20.5)	17(13.4)	31(24.4)	16(12.6)	25(19.7)	48(37.8)	20(15.7)
非因病	22(14.6)	3(2.0)	23(15.2)	10(6.6)	10(6.6)	35(23.2)	10(6.6)
χ²值	1.683	13.425	3.712	2.906	10.696	7.037	5.967
P值	0.195	<0.001	0.054	0.088	0.001	0.008	0.015
累计吸烟年数
<30年	22(16.8)	6(4.6)	21(16.0)	8(6.1)	6(4.6)	32(24.4)	9(6.9)
≥30年	26(17.7)	14(9.5)	33(22.4)	18(12.2)	29(19.7)	51(34.7)	21(14.3)
χ²值	0.039	2.536	1.823	3.078	14.443	3.486	3.957
P值	0.844	0.111	0.177	0.079	<0.001	0.062	0.047
戒烟年数
<3年	34(22.7)	14(9.3)	30(20.0)	17(11.3)	22(14.7)	51(34.0)	17(11.3)
≥3年	14(10.9)	6(4.7)	24(18.8)	9(7.0)	13(10.2)	32(25.0)	13(10.2)
χ²值	6.651	2.233	0.069	1.508	1.277	2.671	0.099
P值	0.010	0.135	0.793	0.219	0.259	0.102	0.753
合计	291(18.4)	104(6.6)	277(17.5)	122(7.7)	137(8.7)	317(20.0)	101(6.4)

表2

表3

表4

戒烟与呼吸系统症状/慢性病关系的logistic回归分析

特征	咳嗽	慢性咳嗽	咳痰	慢性咳痰	喘息	气短	哮喘/慢支
单因素分析
从不吸烟	0.34 (0.25~0.47)	0.25 (0.14~0.47)	0.23 (0.16~0.34)	0.34 (0.21~0.58)	0.41 (0.25~0.66)	0.59 (0.44~0.81)	0.49 (0.28~0.84)
戒烟(总和)	0.65 (0.45~0.92)	0.78 (0.46~1.30)	0.77 (0.55~1.08)	0.94 (0.59~1.51)	1.28 (0.84~1.96)	1.61 (1.18~2.20)	1.66 (1.04~2.67)
因病戒烟	0.80 (0.50~1.26)	1.55 (0.88~2.72)	1.03 (0.66~1.59)	1.32 (0.74~2.34)	2.18 (1.33~3.57)	2.30 (1.55~3.43)	2.57 (1.48~4.56)
非因病戒烟	0.53 (0.33~0.47)	0.20 (0.06~0.65)	0.57 (0.36~0.92)	0.65 (0.33~1.28)	0.63 (0.32~1.25)	1.14 (0.76~1.73)	0.97 (0.48~1.96)
累计吸烟<30年	0.62 (0.38~1.01)	0.48 (0.20~1.13)	0.61 (0.37~1.00)	0.60 (0.28~1.26)	0.43 (0.18~1.00)	1.23 (0.79~1.89)	1.01 (0.49~2.11)
累计吸烟≥30年	0.66 (0.42~1.05)	1.05 (0.58~1.92)	0.92 (0.60~1.40)	1.28 (0.74~2.20)	2.18 (1.37~3.49)	2.01 (1.38~2.95)	2.29 (1.34~3.93)
戒烟前吸烟<3年	0.91 (0.60~1.37)	1.03 (0.56~1.88)	0.79 (0.52~1.22)	1.17 (0.67~2.04)	1.53 (0.92~2.54)	1.95 (1.34~2.85)	1.76 (0.99~3.13)
戒烟前吸烟≥3年	0.38 (0.21~0.68)	0.49 (0.21~1.16)	0.73 (0.46~1.18)	0.69 (0.34~1.42)	1.01 (0.54~1.87)	1.26 (0.82~1.95)	1.55 (0.82~2.94)
特征	咳嗽	慢性咳嗽	咳痰	慢性咳痰	喘息	气短	哮喘/慢支
多因素分析^a
从不吸烟	0.37 (0.26~0.51)	0.27 (0.15~0.50)	0.25 (0.17~0.37)	0.40 (0.23~0.67)	0.43 (0.27~0.71)	0.63 (0.46~0.87)	0.55 (0.31~0.96)
戒烟(总和)	0.62 (0.43~0.89)	0.73 (0.43~1.23)	0.73 (0.51~1.03)	0.88 (0.55~1.43)	1.12 (0.73~1.74)	1.46 (1.06~2.00)	1.46 (0.90~2.37)
因病戒烟	0.77 (0.48~1.23)	1.45 (0.81~2.61)	0.98 (0.63~1.54)	1.24 (0.68~2.24)	1.88 (1.12~3.14)	2.03 (1.35~3.06)	2.22 (1.25~3.95)
非因病戒烟	0.51 (0.32~0.83)	0.20 (0.06~0.63)	0.54 (0.34~0.87)	0.61 (0.31~1.22)	0.58 (0.29~1.14)	1.06 (0.70~1.62)	0.89 (0.44~1.80)
累计吸烟<30年	0.62 (0.38~1.02)	0.46 (0.20~1.10)	0.61 (0.37~1.00)	0.60 (0.28~1.27)	0.42 (0.18~0.98)	1.20 (0.77~1.87)	1.00 (0.48~2.10)
累计吸烟≥30年	0.60 (0.38~0.97)	0.90 (0.48~1.70)	0.83 (0.53~1.29)	1.13 (0.64~2.02)	1.86 (1.12~3.07)	1.62 (1.08~2.44)	1.95 (1.09~3.49)
戒烟前吸烟<3年	0.87 (0.57~1.33)	0.95 (0.51~1.74)	0.76 (0.49~1.18)	1.11 (0.63~1.96)	1.86 (1.12~3.07)	1.78 (1.20~2.62)	1.64 (0.91~2.95)
戒烟前吸烟≥3年	0.35 (0.19~0.63)	0.42 (0.18~1.00)	0.68 (0.42~1.10)	0.61 (0.30~1.28)	1.04 (0.67~1.64)	1.04 (0.67~1.64)	1.32 (0.68~2.55)

表4

表5

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特征	调查人数 (名)	从不吸烟 [名(构成比,%)]	现在吸烟 [名(构成比,%)]	戒烟 [名(构成比,%)]	χ²值	P值
文化程度					9.215	0.010
初中及以下	1127	348(30.9)	570(50.6)	209(18.5)
初中以上	456	176(38.6)	211(46.3)	69(15.1)
职业					1.957	0.376
务农	1066	347(32.5)	522(49.0)	197(18.5)
非务农	517	177(34.2)	259(50.1)	81(15.7)
婚姻					7.961	0.093
未婚	51	25(49.0)	21(41.2)	5(9.8)
已婚	1446	476(32.9)	714(49.4)	256(17.7)
丧偶/离婚	86	23(26.7)	46(53.5)	17(19.8)
年收入(元)					3.303	0.192
<2万	659	226(34.3)	308(46.7)	125(19.0)
≥2万	924	298(32.3)	473(51.2)	153(16.6)
饮酒					65.021	<0.001
否	900	359(39.9)	366(40.7)	175(19.4)
是	683	165(24.1)	415(60.8)	103(15.1)

因素	赋值情况
呼吸系统症状或慢性疾病^a	0=无;1=有
年龄(岁)	连续变量(20~70)
文化程度	0=初中以下;1=初中及以上
职业	0=务农;1=非务农
婚姻	0=未婚;1=已婚;2=丧偶/离婚
年收入	0=2万元以下;1=2万元及以上
饮酒	0=否;1=是

症状/疾病	因病戒烟		戒烟前吸烟≥30年		已戒烟≥3年
症状/疾病	单因素分析	多因素分析	单因素分析	多因素分析	单因素分析	多因素分析
咳嗽	1.51(0.81~2.82)	1.55(0.81~2.96)	1.07(0.57~1.99)	1.19(0.58~2.45)	0.42(0.21~0.82)	0.41(0.20~0.81)
慢性咳嗽	7.62(2.18~26.66)	6.68(1.87~23.80)	2.19(0.82~5.88)	1.77(0.59~5.33)	0.48(0.18~1.28)	0.42(0.15~1.14)
咳痰	1.80(0.99~3.28)	1.94(1.04~3.61)	1.52(0.83~2.78)	1.94(0.95~3.94)	0.92(0.51~1.68)	0.97(0.52~1.78)
慢性咳痰	2.03(0.89~4.65)	2.27(0.94~5.52)	2.15(0.90~5.11)	3.11(1.03~9.40)	0.59(0.25~1.38)	0.63(0.26~1.49)
喘息	3.46(1.59~7.51)	3.28(1.46~7.36)	5.12(2.05~12.78)	5.73(2.05~16.04)	0.66(0.32~1.37)	0.58(0.27~1.25)
气短	2.01(1.20~3.39)	1.97(1.14~3.40)	1.64(0.97~2.78)	1.47(0.81~2.67)	0.65(0.38~1.09)	0.58(0.33~1.00)
哮喘/慢支	2.64(1.19~5.86)	2.66(1.16~6.08)	2.26(1.00~5.13)	2.05(0.81~5.19)	0.88(0.41~1.90)	0.82(0.37~1.78)

淮河流域男性居民戒烟与呼吸道慢性病关系的研究

Effects of smoking cessation on respiratory health and related chronic diseases among male residents in the Huaihe River Basin

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