Association of Time to First Morning Cigarette and Chronic Obstructive Pulmonary Disease Measured by Spirometry in Current Smokers
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Background: Time to first cigarette after waking is an indicator of nicotine dependence. We aimed to identify the association between time to first cigarette and spirometry-proven obstructive respiratory impairment, especially chronic obstructive pulmonary disease, in current smokers.Methods: We included 392 subjects who visited the comprehensive medical examination center of Hallym Univer-sity Sacred Heart Hospital between July 2014 and September 2015. Subjects with lung disease or anemia were ex-cluded. Obstructive pulmonary impairment was defined as <70% of the predicted value of forced expiratory vol-ume in 1 second/forced vital capacity. Subjects were classified into the early (≤30 minutes) and late (>30 minutes) groups based on the time to first cigarette. Logistic regression and linear regression analyses were used for data analysis.Results: Ninety-eight subjects (25%) were classified into the early group. After adjusting for smoking behaviors (cig-arettes per day and smoking duration), socioeconomic status (education and income), age, and physical activity, an early time to first cigarette was found to be associated with an increased risk of obstructive pulmonary impair-ment measured using spirometry (adjusted odds ratio, 2.84; 95% confidence interval, 1.22–6.61).Conclusion: Compared to current smokers with a late time to first cigarette, those with an early time to first ciga-rette had a higher risk of obstructive pulmonary impairment, especially chronic obstructive pulmonary disease. Classifying smoking-related behaviors, especially time to first cigarette, may help target clinical screening for chron-ic obstructive pulmonary disease.
Abstract
Background: Time to first cigarette after waking is an indicator of nicotine dependence. We aimed to identify the association between time to first cigarette and spirometry-proven obstructive respiratory impairment, especially chronic obstructive pulmonary disease, in current smokers.Methods: We included 392 subjects who visited the comprehensive medical examination center of Hallym Univer-sity Sacred Heart Hospital between July 2014 and September 2015. Subjects with lung disease or anemia were ex-cluded. Obstructive pulmonary impairment was defined as <70% of the predicted value of forced expiratory vol-ume in 1 second/forced vital capacity. Subjects were classified into the early (≤30 minutes) and late (>30 minutes) groups based on the time to first cigarette. Logistic regression and linear regression analyses were used for data analysis.Results: Ninety-eight subjects (25%) were classified into the early group. After adjusting for smoking behaviors (cig-arettes per day and smoking duration), socioeconomic status (education and income), age, and physical activity, an early time to first cigarette was found to be associated with an increased risk of obstructive pulmonary impair-ment measured using spirometry (adjusted odds ratio, 2.84; 95% confidence interval, 1.22–6.61).Conclusion: Compared to current smokers with a late time to first cigarette, those with an early time to first ciga-rette had a higher risk of obstructive pulmonary impairment, especially chronic obstructive pulmonary disease. Classifying smoking-related behaviors, especially time to first cigarette, may help target clinical screening for chron-ic obstructive pulmonary disease.
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