COPD and its association with smoking in the Mainland China: a cross-sectional analysis of 0.5 million men and women from ten diverse areas

Om P Kurmi, Liming Li, Jenny Wang, Iona Y Millwood, Junshi Chen, Rory Collins, Yu Guo, Zheng Bian, Jiangtao Li, Biyun Chen, Kaixu Xie, Weifan Jia, Yali Gao, Richard Peto, Zhengming Chen

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Abstract

PURPOSE: In adult Chinese men, smoking prevalence is high, but little is known about its association with chronic respiratory disease, which is still poorly diagnosed and managed.

METHODS: A nationwide study recruited 0.5 million men and women aged 30-79 years during 2004-2008 from ten geographically diverse areas across the Mainland China. Information was collected from each participant regarding smoking and self-reported physician diagnosis of chronic bronchitis/emphysema (CB/E), along with measurement of lung function indices. Logistic regression was used to yield sex-specific odds ratios (ORs) relating smoking to airflow obstruction (AFO), defined as forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) <0.7 and CB/E, adjusting for age, areas, education, and income.

RESULTS: Overall 74% of men were ever regular smokers; among them, 7.2% had AFO compared with 5.4% in never-smokers, yielding an OR of 1.42 (95% confidence interval [CI]: 1.34-1.50). The risk was strongly associated with amount smoked and starting to smoke at a younger age. Among ex-smokers, the OR was more extreme for those who had quit due to illness (OR: 1.86, 95% CI: 1.77-1.96) than those who had quit by choice (OR:1.08, 95% CI: 1.01-1.16). CB/E prevalence was also significantly elevated in ex-smokers who had quit because of ill health (OR:2.79, 95% CI: 2.64-2.95), but not in regular smokers (OR:1.04, 95% CI: 0.96-1.11). Female smokers was rare (3%), but carried an excess risk for AFO (OR:1.53, 95% CI: 1.43-1.65) and, to a lesser extent, for CB/E (OR:1.28, 95% CI: 1.15-1.42).

CONCLUSION: In Mainland China, adult smokers, particularly ex-smokers who had quit because of illness, had significantly higher prevalence of chronic respiratory disease. AFO appeared to be more strongly associated with smoking than self-reported chronic respiratory disease.

Original languageEnglish
Pages (from-to)655-665
Number of pages11
JournalInternational Journal of Chronic Obstructive Pulmonary Disease
Volume10
DOIs
Publication statusPublished - 20 Mar 2015
Externally publishedYes

Bibliographical note

This work is published by Dove Medical Press Limited, and licensed under a Creative Commons Attribution License. The full terms of the License are available at http://creativecommons.org/licenses/by/4.0/. The license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Keywords

  • Adult
  • Age Factors
  • Aged
  • China/epidemiology
  • Cross-Sectional Studies
  • Female
  • Forced Expiratory Volume
  • Health Surveys
  • Humans
  • Logistic Models
  • Lung/physiopathology
  • Male
  • Middle Aged
  • Odds Ratio
  • Prevalence
  • Protective Factors
  • Pulmonary Disease, Chronic Obstructive/diagnosis
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Smoking/adverse effects
  • Smoking Cessation
  • Smoking Prevention
  • Time Factors
  • Vital Capacity

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