scholarly journals Comparison between objective measures of smoking and self-reported smoking status in patients with asthma or COPD: are our patients telling us the truth?

2015 ◽  
Vol 41 (2) ◽  
pp. 124-132 ◽  
Author(s):  
Rafael Stelmach ◽  
Frederico Leon Arrabal Fernandes ◽  
Regina Maria Carvalho-Pinto ◽  
Rodrigo Abensur Athanazio ◽  
Samia Zahi Rached ◽  
...  

OBJECTIVE: Smoking prevalence is frequently estimated on the basis of self-reported smoking status. That can lead to an underestimation of smoking rates. The aim of this study was to evaluate the difference between self-reported smoking status and that determined through the use of objective measures of smoking at a pulmonary outpatient clinic. METHODS: This was a cross-sectional study involving 144 individuals: 51 asthma patients, 53 COPD patients, 20 current smokers, and 20 never-smokers. Smoking status was determined on the basis of self-reports obtained in interviews, as well as through tests of exhaled carbon monoxide (eCO) and urinary cotinine. RESULTS: All of the asthma patients and COPD patients declared they were not current smokers. In the COPD and asthma patients, the median urinary cotinine concentration was 167 ng/mL (range, 2-5,348 ng/mL) and 47 ng/mL (range, 5-2,735 ng/mL), respectively (p < 0.0001), whereas the median eCO level was 8 ppm (range, 0-31 ppm) and 5 ppm (range, 2-45 ppm), respectively (p < 0.05). In 40 (38%) of the patients with asthma or COPD (n = 104), there was disagreement between the self-reported smoking status and that determined on the basis of the urinary cotinine concentration, a concentration > 200 ng/mL being considered indicative of current smoking. In 48 (46%) of those 104 patients, the self-reported non-smoking status was refuted by an eCO level > 6 ppm, which is also considered indicative of current smoking. In 30 (29%) of the patients with asthma or COPD, the urinary cotinine concentration and the eCO level both belied the patient claims of not being current smokers. CONCLUSIONS: Our findings suggest that high proportions of smoking pulmonary patients with lung disease falsely declare themselves to be nonsmokers. The accurate classification of smoking status is pivotal to the treatment of lung diseases. Objective measures of smoking could be helpful in improving clinical management and counseling.

Endocrine ◽  
2019 ◽  
Vol 67 (3) ◽  
pp. 613-622 ◽  
Author(s):  
Eke G. Gruppen ◽  
Jenny Kootstra-Ros ◽  
Anneke Muller Kobold ◽  
Margery A. Connelly ◽  
Daan Touw ◽  
...  

Abstract Purpose The extent to which smoking is associated with thyroid stimulating hormone (TSH), free thyroxine (FT4), and free triiodothyronine (FT3) when taking account of clinical variables including alcohol consumption is unclear. We aimed to determine associations of TSH, FT4, and FT3 levels with current smoking. Methods A cross-sectional study was performed in 5766 euthyroid participants (Prevention of Renal and Vascular End-Stage Disease cohort). Current smoking was determined by self-report, categorized as never, former, and current (≤20 and >20 cigarettes per day). Smoke exposure was determined by urinary cotinine. Results Current smoking of ≤20 and >20 cigarettes per day was associated with lower TSH and higher FT3 levels. FT4 levels were higher in subjects smoking <20 cigarettes per day vs. never and former smokers. Current smokers also consumed more alcohol. Multivariable linear regression analyses adjusted for age, sex, anti-TPO autoantibody positivity, alcohol consumption, and other variables demonstrated that lower TSH, higher FT4 and higher FT3 were associated with smoking ≤20 cigarettes per day vs. subjects who never smoked (P < 0.001, P = 0.018, and P < 0.001, respectively) without a further significant incremental effect of smoking >20 cigarettes per day. In agreement, TSH was inversely, whereas FT4 and FT3 levels were positively associated with urinary cotinine (P < 0.001 for each). In contrast, alcohol consumption >30 g per day conferred higher TSH and lower FT3 levels. Conclusions Cigarette smoking is associated with modestly higher FT4 and FT3, and lower TSH levels, partly opposing effects of alcohol consumption.


2018 ◽  
Vol 44 (6) ◽  
pp. 477-485 ◽  
Author(s):  
Gabriela Pimentel Pinheiro ◽  
Carolina de Souza-Machado ◽  
Andréia Guedes Oliva Fernandes ◽  
Raquel Cristina Lins Mota ◽  
Liranei Limoeiro Lima ◽  
...  

ABSTRACT Objective: To determine the frequency of active smoking among patients with asthma and individuals without asthma by self-report and urinary cotinine measurement. Methods: This was a cross-sectional study conducted in the city of Salvador, Brazil, and involving 1,341 individuals: 498 patients with severe asthma, 417 patients with mild-to-moderate asthma, and 426 individuals without asthma. Smoking status was determined by self-report (with the use of standardized questionnaires) and urinary cotinine measurement. The study variables were compared with the chi-square test and the Kruskal-Wallis test. Results: Of the sample as a whole, 55 (4.1%) reported being current smokers. Of those, 5 had severe asthma, 17 had mild-to-moderate asthma, and 33 had no asthma diagnosis. Of the 55 smokers, 32 (58.2%) were daily smokers and 23 (41.8%) were occasional smokers. Urinary cotinine levels were found to be high in self-reported nonsmokers and former smokers, especially among severe asthma patients, a finding that suggests patient nondisclosure of smoking status. Among smokers, a longer smoking history was found in patients with severe asthma when compared with those with mild-to-moderate asthma. In addition, the proportion of former smokers was higher among patients with severe asthma than among those with mild-to-moderate asthma. Conclusions: Former smoking is associated with severe asthma. Current smoking is observed in patients with severe asthma, and patient nondisclosure of smoking status occurs in some cases. Patients with severe asthma should be thoroughly screened for smoking, and findings should be complemented by objective testing.


2019 ◽  
Vol 6 (4) ◽  
pp. 1116
Author(s):  
Aravind C. ◽  
Ragul B. ◽  
Monisha .

Background: Secondhand Smoke (SHS) exposure is known to be associated with various cardiovascular and respiratory problems but its effect on pulmonary function remains unexplored. This study was done to evaluate the effect of Secondhand Smoke (SHS) exposure on lung function among non-smoking population.Methods: This cross-sectional study was conducted in Bahour, Pondicherry from 2017-2018.  350 participants, age 40 year and older, with no respiratory symptoms or prior lung diseases were included in this study. Both self-reported history and measurement of urinary cotinine level were used to evaluate the smoking status. Spirometry data, including FVC and FEV1 were used to assess lung function. Diverse variables between groups were compared using T- test and Chi-square test. Analysis of covariance (ANCOVA) adjusted for age, height, alcohol consumption, and level of exercise was used to see any statistical differences in lung function parameters between non-SHS exposed and SHS-exposed groups.Results: Among 350 non-smokers, 120 were SHS-exposed. The urinary cotinine levels clearly distinguished SHS exposure, and the mean urinary cotinine levels were 7±0.3 and 11±0.4 in non-SHS exposed group vs SHS-exposed group, respectively. However, both groups had no significant difference in lung function and was found normal.Conclusions: SHS exposure urinary cotinine is a valuable marker.


2012 ◽  
Vol 9 (4) ◽  
pp. 233-237
Author(s):  
S Ganesh Kumar ◽  
S H Subba ◽  
B Unnikrishnan ◽  
A Jain ◽  
S Badiger

Background Smoking among health care personnel such as medical students is an important public health issue. More effective measures to reduce tobacco smoking among medical students are needed worldwide. Very few studies had been conducted in past in India and other developing countries to understand the magnitude of problem. Objectives To determine the prevalence and associated factors of current smoking among medical students. Methods Cross sectional study was conducted during January and February 2009 among 333 study subjects selected randomly from four batches of a teaching institution. Subjects were administered a self administered pre tested questionnaire and smoking status was assessed as per the criteria laid down by WHO. Proportion, chi square test and multiple logistic regression analysis were used for statistical analysis. Results The prevalence of current smoking was found to be 22.4% (67). There were widespread deficiencies in knowledge of smoking among students of different classes, as an important causal factor in many diseases like gastro intestinal malignancy, heart problems, asthma, and emphysema. It was found that only half of them were willing to quit smoking (33). Fourth year students (OR=2.54) and presence of peer pressure (OR=21.91) had independent significant association with current smoking. Conclusion Prevalence of smoking among medical students is high that warrants adoption of comprehensive smoking control interventions among them.DOI: http://dx.doi.org/10.3126/kumj.v9i4.6335 Kathmandu Univ Med J 2011;9(4):233-7


2016 ◽  
Vol 4 (2) ◽  
pp. 277-282 ◽  
Author(s):  
Beti Zafirova-Ivanovska ◽  
Jagoda Stojkovikj ◽  
Dejan Dokikj ◽  
Sasha Anastasova ◽  
Angela Debresliovska ◽  
...  

BACKGROUND: High blood cholesterol is part of metabolic syndrome and can be caused by medical conditions or bad dietary habits.AIM: The aim of the study was to investigate the prevalence of hypercholesterolemia in privies diagnosed patients with the severe and very severe stage of COPD, which were stable.MATERIAL AND METHODS: We investigated 100 subjects, all of them smokers, with smoking status >10 years, stratified into two groups: with severe and very severe stage of the disease. It was clinical, randomized, cross-sectional study. Besides demographic parameters and functional parameters, body mass index, cholesterol, LDL, and HDL were investigated.RESULTS: In the group of patients with very severe COPD were recorded significantly higher average values of cholesterol (6.16 ± 1.5 vs. 5.61 ± 1.1, p = 0.039). As independent significant factors influencing cholesterol in the group with a very severe COPD were confirmed the age of the patients (p = 0.005), LDL (p = 0.004) and HDL (p = 0.002). In the group with severe COPD, only LDL was confirmed as an independent significant factor that has an impact on cholesterol (p < 0.0001).CONCLUSION: The results of our survey demonstrated a high level of blood cholesterol and LDL, and low level of blood HDL in both investigated group’s patients with COPD.


Author(s):  
Melvin K Mathews ◽  
Abubaker Siddiq ◽  
Bharathi D R

Background: Chronic obstructive pulmonary disease (COPD) is preventable and treatable disease state characterized by air flow limitation that is not fully reversible. Severity of the symptoms is increased during exacerbations. Objectives: The purpose of the study is to assess and improve the knowledge regarding COPD among study subjects. Materials and Methods: A Cross-sectional interventional study was carried out among the peoples in selected areas of the Chitradurga city for a period of six months. Result: A total 207 subjects enrolled in the study in that 155 male and 52 females. In our study mean score of post test was more (5.87±1.68) when compare to pre-test (2.63±1.46) which show significant increase in their knowledge after educating them (p=0.000). A total of 207 subjects were enrolled into the study. SPSS Software was used to calculate the statistical estimation. Paired t-test was used to detect the association status of different variables. Conclusion: The relatively good level of COPD awareness needs to be maintained to facilitate future prevention and control of the disease. This study had identified that negative illness perceptions should be targeted, so that they will not avoid patients from seeking for COPD treatment and adhere to it. Key words: Cross sectional study, Knowledge, practice, COPD.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Peng Sun ◽  
Mengqi Chen ◽  
Xiaofan Guo ◽  
Zhao Li ◽  
Ying Zhou ◽  
...  

Abstract Background To investigate the combined effect of hypertension and hyperuricemia to the risk of ischemic stroke in a rural Chinese population. Methods The cross-sectional study was conducted from 2012 to 2013 in a rural area of China. After exclusion for missing data, we finally included 11,731 participants into analysis. Results After adjusting for age, current smoking, current drinking, BMI, TG, HDL-C and eGFR, hypertension was significantly associated with ischemic stroke in men (OR: 2.783, 95% CI: 1.793, 4.320) and in women (OR: 4.800, 95% CI: 2.945, 7.822). However, hyperuricemia was significantly associated with ischemic stroke only in women (OR: 1.888, 95% CI: 1.244, 2.864). After full adjustment, participants with both hypertension and hyperuricemia had 8.9 times higher risk than those without them. Finally, the interaction between hypertension and hyperuricemia was statistically significant only in women rather than in men after full adjustment. Conclusions This study demonstrated the positive correlations between hypertension, hyperuricemia and ischemic stroke. Our study also demonstrated the joint effect between hypertension and hyperuricemia towards ischemic stroke only in women, not in men.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Michal Kulecki ◽  
Dariusz Naskret ◽  
Mikolaj Kaminski ◽  
Dominika Kasprzak ◽  
Pawel Lachowski ◽  
...  

AbstractThe non-dipping pattern is nighttime systolic blood pressure (SBP) fall of less than 10%. Several studies showed that the non-dipping pattern, increased mean platelet volume (MPV), and platelet distribution width (PDW) are associated with elevated cardiovascular risk. Hypertensives with the non-dipping pattern have higher MPV than the dippers but this relationship was never investigated among people with type 1 diabetes mellitus (T1DM). This study aimed to investigate the association between the central dipping pattern and platelet morphology in T1DM subjects. We measured the central and brachial blood pressure with a validated non-invasive brachial oscillometric device—Arteriograph 24—during twenty-four-hour analysis in T1DM subjects without diagnosed hypertension. The group was divided based on the central dipping pattern for the dippers and the non-dippers. From a total of 62 subjects (32 males) aged 30.1 (25.7–37) years with T1DM duration 15.0 (9.0–20) years, 36 were non-dippers. The non-dipper group had significantly higher MPV (MPV (10.8 [10.3–11.5] vs 10.4 [10.0–10.7] fl; p = 0.041) and PDW (13.2 [11.7–14.9] vs 12.3 [11.7–12.8] fl; p = 0.029) than dipper group. Multivariable logistic regression revealed that MPV (OR 3.74; 95% CI 1.48–9.45; p = 0.005) and PDW (OR 1.91; 95% CI 1.22–3.00; p = 0.005) were positively associated with central non-dipping pattern adjusting for age, sex, smoking status, daily insulin intake, and height. MPV and PDW are positively associated with the central non-dipping pattern among people with T1DM.


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