Smoking cessation and the risk of hospitalization for pneumonia

被引:16
作者
Cecere, Laura M. [1 ,2 ]
Williams, Emily C. [1 ,3 ]
Sun, Haili [1 ]
Bryson, Chris L. [1 ,4 ]
Clark, Brendan J. [5 ]
Bradley, Katharine A. [1 ,3 ,4 ,6 ]
Au, David H. [1 ,2 ]
机构
[1] Puget Sound Hlth Care Syst, Dept Vet Affairs, NW Ctr Excellence, HSR&D, Seattle, WA USA
[2] Univ Washington, Div Pulm & Crit Care Med, Dept Med, Seattle, WA USA
[3] Univ Washington, Dept Hlth Serv, Seattle, WA 98195 USA
[4] Univ Washington, Dept Med, Div Gen Internal Med, Seattle, WA USA
[5] Univ Colorado Denver, Div Pulm Sci & Crit Care Med, Aurora, CO USA
[6] Grp Hlth Res Inst, Seattle, WA USA
关键词
Pneumonia; Smoking cessation; COPD; COMMUNITY-ACQUIRED PNEUMONIA; OBSTRUCTIVE PULMONARY-DISEASE; ALCOHOL SCREENING SCORES; UNITED-STATES; HEALTH-STATUS; OLDER-ADULTS; MORTALITY; CARE; POPULATION; VETERANS;
D O I
10.1016/j.rmed.2012.03.018
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Smoking increases the risk of hospitalization for pneumonia, yet it is unknown if smoking cessation changes this risk. We sought to determine if smoking cessation and the duration of abstinence from tobacco reduce the risk of pneumonia hospitalization. Methods: We performed secondary analysis of data collected from male United States Veterans participating in a randomized trial. We used Cox proportional-hazard models to estimate risk of hospitalization for pneumonia within one year of enrollment. We adjusted for confounders, including: demographics, comorbidity, alcohol use, prior pneumonia, inhaled corticosteroid use, and intensity of tobacco exposure. Among a restricted cohort excluding never smokers, we assessed for effect modification by a diagnosis of chronic obstructive pulmonary disease (COPD). Results: Of the 25,235 participants, we identified 6720 current, 13,625 former, and 4890 never smokers. Compared to current smokers, never smokers had a decreased (adjusted HR 0.48, 95% Cl 0.31-0.74), while former smokers had no difference in (adjusted HR 0.83, 95% Cl 0.63-1.09) risk of hospitalization for pneumonia. Among participants without COPD, former smokers had a lower risk of hospitalization (adjusted HR 0.65, 95% Cl 0.45-0.95). However, this lower risk was isolated to those who quit tobacco more than 10 years previously (adjusted HR 0.62, 95% CI 0.41-0.93). Among those with COPD, there was no difference in risk with smoking cessation or duration of remaining tobacco-free. Conclusions: Tobacco cessation is likely important in reducing hospital admissions for pneumonia, but its benefit depends on duration of smoking cessation and is likely attenuated in the presence of COPD. Published by Elsevier Ltd.
引用
收藏
页码:1055 / 1062
页数:8
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