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

doi:10.19983/j.issn.2096-8493.20220036

Abstract

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

CLC Number:

R163

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

Figures/Tables 5

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)

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)

References 26

[1]	中国疾病预防控制中心. 2018中国成人烟草调查内容摘要[EB/OL]. (2019-08-14)[2021-04-08]. https://www.chinacdc.cn/jkzt/sthd_3844/slhd_12885/201908/t20190814_204616.html.
[2]	世界卫生组织. 烟草在中国[EB/OL]. [2021-06-04]. https://www.who.int/china/zh/health-topics/tobacco.
[3]	Chen Z, Peto R, Zhou M, et al. China Kadoorie Biobank (CKB) collaborative group. Contrasting male and female trends in tobacco-attributed mortality in China: evidence from successive nationwide prospective cohort studies. Lancet, 2015, 386(10002):1447-1456. doi: 10.1016/S0140-6736(15)00340-2. doi: 10.1016/S0140-6736(15)00340-2 URL
[4]	王昕, 吕筠, 郭彧, 等. 中国慢性病前瞻性研究:10个项目地区成年人群吸烟行为特征差异分析. 中华流行病学杂志 2015, 36(11):1200-1204. doi: 10.3760/cma.j.issn.0254-6450.2015.11.004. doi: 10.3760/cma.j.issn.0254-6450.2015.11.004
[5]	Hikichi M, Mizumura K, Maruoka S, et al. Pathogenesis of chronic obstructive pulmonary disease (COPD) induced by cigarette smoke.J Thorac Dis,2019,11 Suppl 17:S2129-S2140. doi: 10.21037/jtd.2019.10.43. doi: 10.21037/jtd.2019.10.43
[6]	Anthonisen NR, Connett JE, Murray RP. Smoking and lung function of Lung Health Study participants after 11 years. Am J Respir Crit Care Med, 2002, 166(5):675-679. doi: 10.1164/rccm.2112096. doi: 10.1164/rccm.2112096 URL
[7]	Kanner RE, Anthonisen NR, Connett JE, et al. Lower respira-tory illnesses promote FEV(1) decline in current smokers but not ex-smokers with mild chronic obstructive pulmonary disease: results from the lung health study. Am J Respir Crit Care Med, 2001, 164(3):358-364. doi: 10.1164/ajrccm.164.3.2010017. doi: 10.1164/ajrccm.164.3.2010017 URL
[8]	Godtfredsen NS, Lange P, Prescott E, et al. Changes in smoking habits and risk of asthma: a longitudinal population based study. Eur Respir J, 2001, 18(3):549-554. doi: 10.1183/09031936.01.00100801. doi: 10.1183/09031936.01.00100801 pmid: 11589354
[9]	Lam TH, He Y, Shi QL, et al.Smoking, quitting, and mortality in a Chinese cohort of retired men. Ann Epidemiol, 2002, 12(5):316-320. doi: 10.1016/s1047-2797(01)00258-7. doi: 10.1016/s1047-2797(01)00258-7 URL
[10]	Pan A, Wang Y, Talaei M, et al. Relation of active, passive, and quitting smoking with incident type 2 diabetes: a syste-matic review and meta-analysis. Lancet Diabetes Endocrinol, 2015, 3(12):958-967. doi: 10.1016/S2213-8587(15)00316-2. doi: 10.1016/S2213-8587(15)00316-2 URL
[11]	Jha P, Ramasundarahettige C, Landsman V, et al. 21st-century hazards of smoking and benefits of cessation in the United States. N Engl J Med, 2013, 368(4):341-350. doi: 10.1056/NEJMsa1211128.. doi: 10.1056/NEJMsa1211128. URL
[12]	张金良, 吕占禄, 邹天森, 等. 淮河流域农村女性居民呼吸系统症状报告情况及其影响因素分类树分析. 中国公共卫生, 2021, 37(11):1652-1658. doi: 10.11847/zgggws1134446. doi: 10.11847/zgggws1134446
[13]	贾晓蓉, 綦斐, 李善鹏, 等. 青岛市成人戒烟现况及影响因素分析. 中华疾病控制杂志, 2017, 21(5):444-448. doi: 10.16462/j.cnki.zhjbkz.2017.05.004. doi: 10.16462/j.cnki.zhjbkz.2017.05.004
[14]	杨桂丽, 徐越, 陈镭, 等. 温州市部分城市与农村吸烟者吸烟和戒烟现况及影响因素分析. 中华健康管理学杂志, 2016, 10(2):105-111. doi: 10.3760/cma.j.issn.1674-0815.2016.02.006. doi: 10.3760/cma.j.issn.1674-0815.2016.02.006
[15]	宋桂德, 解鸿翔, 张宏, 等. 天津市农村居民吸烟、饮酒现状分析. 中国慢性病预防与控制, 2007(3):209-212. doi: 10.3969/j.issn.1004-6194.2007.03.006. doi: 10.3969/j.issn.1004-6194.2007.03.006
[16]	宋慧慧, 刘言训,王健, 等. 山东省部分地区农村男性吸烟者既往戒烟次数的影响因素分析. 中华流行病学杂志, 2016, 37(9):1238-1241. doi: 10.3760/cma.j.issn.0254-6450.2016.09.011. doi: 10.3760/cma.j.issn.0254-6450.2016.09.011
[17]	Zhi K, Huang J, Deng S, et al. Decreased smoking initiation among male youths in China: an urban-rural comparison. Int J Public Health, 2016, 61(4):417-425. doi: 10.1007/s00038-016-0795-y. doi: 10.1007/s00038-016-0795-y URL
[18]	丛舒, 王宁, 樊静, 等. 我国40岁及以上吸烟人群烟草依赖严重程度及其影响因素分析. 中华流行病学杂志, 2021, 42(5):807-813. doi: 10.3760/cma.j.cn112338-20210204-00092. doi: 10.3760/cma.j.cn112338-20210204-00092
[19]	李婧辰, 张梅, 李镒冲, 等. 我国40岁及以上人群慢性呼吸系统疾病症状流行现况及影响因素研究. 中华流行病学杂志, 2018, 39(6):786-791. doi: 10.3760/cma.j.issn.0254-6450.2018.06.018. doi: 10.3760/cma.j.issn.0254-6450.2018.06.018
[20]	Li D, Sundar IK, McIntosh S, et al. Association of smoking and electronic cigarette use with wheezing and related respiratory symptoms in adults: cross-sectional results from the Population Assessment of Tobacco and Health (PATH) study, wave 2. Tob Control, 2020, 29(2):140-147. doi: 10.1136/tobaccocontrol-2018-054694. doi: 10.1136/tobaccocontrol-2018-054694
[21]	Liu Y, Pleasants RA, Croft JB, et al. Smoking duration, respiratory symptoms, and COPD in adults aged ronic cigarette use with wheezing . Int J Chron Obstruct Pulmon Dis, 2015, 10:1409-1416. doi: 10.2147/COPD.S82259. doi: 10.2147/COPD.S82259
[22]	Backman H, Hedman L, Jansson SA, et al. Prevalence trends in respiratory symptoms and asthma in relation to smoking-two cross-sectional studies ten years apart among adults in northern Sweden. World Allergy Organ J, 2014, 7(1): 1.doi: 10.1186/1939-4551-7-1. doi: 10.1186/1939-4551-7-1
[23]	于旭华, 吴蕾, 胡涛, 等. 香烟烟雾对气道糖皮质激素受体表达及黏液分泌的影响. 广东医学, 2015, 36(4):522-525. doi: 10.13820/j.cnki.gdyx.20150214.005. doi: 10.13820/j.cnki.gdyx.20150214.005
[24]	Pelkonen M, Notkola IL, Tukiainen H, et al. Smoking cessation, decline in pulmonary function and total mortality: a 30 year follow up study among the Finnish cohorts of the Seven Countries Study. Thorax, 2001, 56(9):703-707. doi: 10.1136/thorax.56.9.703. doi: 10.1136/thorax.56.9.703 pmid: 11514691
[25]	Scanlon PD, Connett JE, Waller LA, et al.Smoking cessation and lung function in mild-to-moderate chronic obstructive pulmonary disease. The Lung Health Study. Am J Respir Crit Care Med, 2000, 161161(2 Pt 1):381-390. doi: 10.1164/ajrccm.161.2.9901044. doi: 10.1164/ajrccm.161.2.9901044 URL
[26]	韩成龙, 李彩宁, 孙安华, 等. 吸烟、饮酒与消化性溃疡关系的病例对照研究. 解放军预防医学杂志, 1993, 11(3):190-194.

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)