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Female smokers are at greater risk of airflow obstruction than male smokers: UK Biobank

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Title: Female smokers are at greater risk of airflow obstruction than male smokers: UK Biobank
Authors: Amaral, AF
Strachan, DP
Burney, PG
Jarvis, DL
Item Type: Journal Article
Abstract: RATIONALE: The prevalence of chronic obstructive pulmonary disease (COPD) is increasing faster among women than among men. <br><br> Objectives: To examine sex differences in the risk of airflow obstruction (COPD hallmark) in relation to smoking history. <br><br> Methods: We analysed 149,075 women and 100,252 men taking part in the UK Biobank, who had provided spirometry measurements and information on smoking. The association of airflow obstruction with smoking characteristics was assessed, by sex, using regression analysis. The shape of this relationship was examined using restricted cubic splines. <br><br> Measurements and main results: The association of airflow obstruction with smoking status was stronger in women (ORex=1.44; ORcurrent=3.45) than in men (ORex=1.25; ORcurrent=3.06) (P-interaction=5.6x10(-4)). In both sexes, the association of airflow obstruction with cigarettes/day, duration and pack-years did not follow a linear pattern, with the increase in risk at lower doses being steeper among women. For equal doses of exposure, sex differences were present in both ex- and current smokers for cigarettes/day (P-interactionex=6.0x10(-8); P-interactioncurrent=1.1x10(-5)), duration (P-interactionex=7.9x10(-4); P-interactioncurrent=0.004) and pack-years (P-interactionex=6.6x10(-18); P-interactioncurrent=1.3x10(-6)). Overall those who started smoking before 18 were more likely to have airflow obstruction, but a sex difference in this association was not clear. For equal time since quitting, the reduction in risk among women seemed less marked than among men. <br><br> Conclusion: Exposed to the same dose of smoking, women show higher risk of airflow obstruction than men. This could partly explain the increasingly smaller sex difference in the prevalence of COPD, especially in countries where smoking patterns have become similar between women and men.
Issue Date: 1-May-2017
Date of Acceptance: 20-Dec-2016
URI: http://hdl.handle.net/10044/1/45106
DOI: 10.1164/rccm.201608-1545OC
ISSN: 1535-4970
Publisher: American Thoracic Society
Start Page: 1226
End Page: 1235
Journal / Book Title: American Journal of Respiratory and Critical Care Medicine
Volume: 195
Issue: 9
Copyright Statement: © 2017 the American Thoracic Society. Originally Published in: Amaral et al, Female Smokers are at Greater Risk of Airflow Obstruction than Male Smokers: UK Biobank, American Journal of Respiratory and Critical Care Medicine, 2017. DOI: 10.1164/rccm.201608-1545OC. The final publication is available at https://dx.doi.org/10.1164/rccm.201608-1545OC
Sponsor/Funder: British Lung Foundation
Funder's Grant Number: PO Nr 28001631
Keywords: Science & Technology
Life Sciences & Biomedicine
Critical Care Medicine
Respiratory System
General & Internal Medicine
airflow obstruction
sex differences
smoking
REPORTED SMOKING HISTORY
GENDER-DIFFERENCES
CIGARETTE-SMOKING
PULMONARY-DISEASE
SEX-DIFFERENCES
LUNG-FUNCTION
COPD
REPRESENTATIVENESS
SUSCEPTIBILITY
RELIABILITY
airflow obstruction
sex differences
smoking
Adult
Aged
Airway Obstruction
Female
Humans
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive
Regression Analysis
Risk Factors
Sex Factors
Smoking
Spirometry
United Kingdom
Humans
Pulmonary Disease, Chronic Obstructive
Airway Obstruction
Spirometry
Risk Factors
Regression Analysis
Smoking
Sex Factors
Adult
Aged
Middle Aged
Female
Male
United Kingdom
11 Medical and Health Sciences
Respiratory System
Publication Status: Published
Online Publication Date: 2017-01-11
Appears in Collections:Department of Infectious Diseases
National Heart and Lung Institute
Faculty of Medicine