Korean J Fam Med.  2018 Mar;39(2):67-73. 10.4082/kjfm.2018.39.2.67.

Association of Time to First Morning Cigarette and Chronic Obstructive Pulmonary Disease Measured by Spirometry in Current Smokers

• Kim G
• Song H
• Park K
• Noh H
• Lee E
• Lee H
• Kim H
• Paek Y

• KMID: 2411626
• DOI: http://doi.org/10.4082/kjfm.2018.39.2.67

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 University Sacred Heart Hospital between July 2014 and September 2015. Subjects with lung disease or anemia were excluded. Obstructive pulmonary impairment was defined as < 70% of the predicted value of forced expiratory volume 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 (cigarettes 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 impairment 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 cigarette 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 chronic obstructive pulmonary disease.

Keyword

Smoking; Chronic Obstructive Pulmonary Disease; Time to First Cigarette; Nicotine Dependence; Respiratory Function Tests

MeSH Terms

Anemia
Forced Expiratory Volume
Heart
Linear Models
Logistic Models
Lung Diseases
Mass Screening
Motor Activity
Odds Ratio
Pulmonary Disease, Chronic Obstructive*
Respiratory Function Tests
Smoke
Smoking
Social Class
Spirometry*
Statistics as Topic
Tobacco Products*
Tobacco Use Disorder
Vital Capacity
Smoke