Demographics and medical disorders associated with smoking: a population-based study
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RESEARCH ARTICLE
Open Access
Demographics and medical disorders associated with smoking: a populationbased study Wei-Sheng Chung1,2,3, Pei-Tseng Kung4,5†, Hui-Yun Chang2 and Wen-Chen Tsai2*†
Abstract Background: Few studies have investigated factors associated with smoking behaviors. In this population-based study, we investigated demographics and medical comorbid diseases to establish a prediction model for smoking behaviors by using the National Health Interview Survey (NHIS) and National Health Insurance Research Database (NHIRD). Methods: We enrolled individuals aged ≥40 years who had participated in the NHIS in 2001, 2005, and 2009. We identified the smoking behaviors of the study participants in the NHIS. Smoking behaviors were divided into ever smokers (current smokers and ex-smokers) and nonsmokers (never smokers).We defined medical comorbid disorders of the study participants by using medical claim data from the NHIRD. We used multivariable logistic regression models to calculate the adjusted odds ratio and 95% confidence interval for variables associated with smoking. The significant variables in the multivariable model were included in the receiver operating characteristic curves (ROC) to predict the sensitivity and specificity of the model. Results: In total, 26,375 participants (12,779 men and 13,596 women) were included in the analysis. The prevalence of smoking was 39.29%. The mean ages of the 16,012 nonsmokers were higher than those of the 10,363 smokers (57.86 ± 12.92 years vs. 53.59 ± 10.82 years). Men outnumbered women among smokers (68.18% vs. 31.82%). Male sex, young age and middle age, being insured categories, residence in suburban areas, and chronic obstructive pulmonary disease (COPD) were independent factors associated with smoking. The area under the ROC curve of these significant factors to predict smoking behaviors was 71.63%. Conclusion: Sex, age, insured categories, residence in suburban areas, and COPD were associated with smoking in people. Keywords: Smoking, Sex, Age, Chronic obstructive pulmonary disease, Receiver operating curve
Introduction Worldwide, the overall morbidity and mortality in adult smokers are approximately three times higher than those in adult nonsmokers [1]. Smoking leads to diseases and disability in nearly all organs of the body [2]. The major causes of excess mortality among smokers include cancer, pulmonary diseases, and vascular diseases [1]. * Correspondence: [email protected] † Pei-Tseng Kung and Wen-Chen Tsai contributed equally to this work. 2 Department of Health Services Administration, China Medical University, No. 91, Hsueh-Shih Road,, Taichung 40402, Taiwan Full list of author information is available at the end of the article
Hypertension, coronary artery disease (CAD), and stroke are well-established factors of morbidity relating to tobacco smoking [3–5]. Chronic obstructive pulmonary disease (COPD), a heterogeneous disorder causing progressively irreversible airflow limitation, is strongly related to smoking. Smoking accounts for 8 out
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