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- Title
The association of pipe and cigar use with cotinine levels, lung function, and airflow obstruction: a cross-sectional study.
- Authors
Rodriguez J; Jiang R; Johnson WC; MacKenzie BA; Smith LJ; Barr RG; Rodriguez, Josanna; Jiang, Rui; Johnson, W Craig; MacKenzie, Barbara A; Smith, Lewis J; Barr, R Graham
- Abstract
<bold>Background: </bold>Cigarette smoking is the major cause of chronic obstructive pulmonary disease, but studies on the contribution of other smoking techniques are sparse.<bold>Objective: </bold>To determine whether pipe and cigar smoking was associated with elevated cotinine levels, decrements in lung function, and increased odds of airflow obstruction.<bold>Design: </bold>Cross-sectional study.<bold>Setting: </bold>Population-based sample from 6 U.S. communities.<bold>Participants: </bold>Men and women aged 48 to 90 years without clinical cardiovascular disease at enrollment who were part of MESA (Multi-Ethnic Study of Atherosclerosis).<bold>Measurements: </bold>The MESA Lung Study measured spirometry according to American Thoracic Society guidelines and urine cotinine levels by immunoassay on a subsample of MESA. Pipe-years and cigar-years were calculated as years from self-reported age of starting to age of quitting (or to current age in current users) multiplied by pipe-bowls or cigars per day.<bold>Results: </bold>Of 3528 participants, 9% reported pipe smoking (median, 15 pipe-years), 11% reported cigar smoking (median, 6 cigar-years), and 52% reported cigarette smoking (median, 18 pack-years). Self-reported current pipe and cigar smokers had elevated urine cotinine levels compared with never-smokers. Pipe-years were associated with decrements in FEV(1), and cigar-years were associated with decrements in the FEV(1)-FVC ratio. Participants who smoked pipes or cigars had increased odds of airflow obstruction whether they had also smoked cigarettes (odds ratio, 3.43 [95% CI, 1.75 to 6.71]; P < 0.001) or not (odds ratio, 2.31 [CI, 1.04 to 5.11]; P = 0.039) compared with participants with no smoking history.<bold>Limitation: </bold>Cross-sectional design.<bold>Conclusion: </bold>Pipe and cigar smoking increased urine cotinine levels and was associated with decreased lung function and increased odds of airflow obstruction, even in participants who had never smoked cigarettes.<bold>Primary Funding Source: </bold>National Heart, Lung, and Blood Institute, National Institutes of Health.
- Publication
Annals of Internal Medicine, 2010, Vol 152, Issue 4, p201
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-152-4-201002160-00004