Study On The Relationship Between Smoking,passive Smoking And COPD Among Residents Aged 30 And Above In Sichuan Province

Research purposes:1.Based on the population of China Kadoorie Biobank(CKB),the epidemic characteristics of smoking and passive smoking and the incidence of Chronic obstructive pulmonary diseases(COPD)among residents aged 30 and above in Sichuan Province were described.2.In-depth analysis of the relationship between smoking,passive smoking and COPD,to find smoking,passive smoking behavior characteristics on the risk of COPD,so as to provide reference for scientific tobacco control.3.To analyze the relationship between the behavior characteristics of smoking and passive smoking and the incidence of COPD among men and women,and to explore the population who need to be paid attention to,so as to provide scientific reference for the classified intervention of COPD in people among men and women.Subjects and Methods:Based on CKB subjects in Sichuan Province,a prospective cohort study,baseline data,resurvey data and long-term follow-up data was used in our study.Cox proportional hazard regression model was used to accurately analyze the risk of behavioral characteristics of smoking and passive smoking on COPD.Combined with resurvey data,Rosner regression calibration method was used to correct the relationship between smoking,passive smoking and COPD.Results:1.A total of 46540 people aged 30 and above were included in this study,with a cumulative follow-up of 509254.18 person-years and an average follow-up of 10.94 years.Among them,17306 were males,accounting for 37.19%,with an average age of 50.38±10.17 years.The smoking rate was 36.37%,and the average daily smoking volume of smokers was 10～20g/d,accounting for 49.16%,the baseline cumulative smoking volume of smokers was ≥250000g,accounting for 45.82%.Cigarettes were the main types of tobacco currently and beginning smoking,accounting for 66.44% and 72.41%,the age of starting smoking was over 18 years old,accounting for 75.57%,and the smoking site was mainly inhaled into the mouth,accounting for 40.68%.The exposure rate of passive smoking was 73.55%,the exposure time of passive smoking was mainly 1～7h/w,accounting for 40.03%,mainly current smoker cohabitation experience,accounting for51.25%,and the years of cohabitation with smokers are mainly 31-60 years,accounting for 49.74%.There were 3101 new cases of COPD,the cumulative incidence rate was6.66%,and the incidence density was 608.93/100000 person-years.2.After adjusting the confounding factors and correcting the regression dilution bias,multivariate Cox regression analysis showed that the current smoking population,the current smoking type was mixed smoking,the first smoking type was mixed smoking,the age of starting smoking was <18 years old and those who inhaled to the throat when smoking had the highest risk of COPD,with HR of 1.51(95%CI:1.45～1.58),2.16(95%CI:1.97～2.36),2.55(95%CI:2.23～2.92),1.88(95%CI:1.79～1.98)and 2.07(95%CI:1.98～2.15).There was a dose-response relationship between the average daily smoking volume and the risk of COPD,the greater the average daily smoking volume,the higher the risk of COPD,and the gender difference in the risk of COPD was particularly significant in the three aspects of average daily smoking volume,age of starting smoking and depth of smoking inhalation,female population was higher than male.3.After adjusting confounding factors and correcting dilution bias,multivariate Cox regression analysis showed that passive smoking exposure duration >7h/w,exposed to passive smoking every day or almost every day,previous smoker cohabitation experience,cohabitation with smokers for more than 60 years population had the highest risk of COPD,with HR of 1.92(95%CI:1.90～1.95),2.04(95%CI:2.01～2.07),1.27(95%CI:1.22～1.33)and 1.74(95%CI:1.68～1.81).There was a dose-response relationship between the exposure time of passive smoking,the frequency of passive smoking exposure,the years of cohabitation with smokers and the risk of COPD,and the gender difference in the risk of COPD was particularly significant in the three aspects of exposure time of passive smoking,frequency of passive smoking exposure,years of cohabitation with smokers,male population was higher than female.Conclusions:1.The incidence of COPD,smoking rate and exposure rate of passive smoking were higher.2.Smoking and passive smoking behavior characteristics were related to the increased risk of COPD.3.There were prominent gender differences in the relationship between smoking and passive smoking behavior characteristics and COPD.4.Strengthen tobacco control management,carry out accurate intervention on the behavioral characteristics of smoking and passive smoking in different populations,and improve public awareness of the relationship between smoking,passive smoking and COPD.