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- Hedman, Linnea, et al.
(författare)
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Association of Electronic Cigarette Use With Smoking Habits, Demographic Factors, and Respiratory Symptoms
- 2018
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Ingår i: Jama Network Open. - : American Medical Association (AMA). - 2574-3805. ; 1:3
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Tidskriftsartikel (refereegranskat)abstract
- IMPORTANCE There is an ongoing debate about whether electronic cigarettes (e-cigarettes) are the solution to the tobacco epidemic or a new public health threat. Large representative studies are needed to study e-cigarette use in the general population, but hardly any have been published. OBJECTIVES To estimate the prevalence of e-cigarette use and to investigate the association of e-cigarette use with smoking habits, demographic factors, and respiratory symptoms. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional, population-based study of random samples of the population, performed within the Obstructive Lung Disease in Northern Sweden (OLIN) study and West Sweden Asthma Study (WSAS). The same validated questionnaire including identical questions was used in OLIN and WSAS. In 2016, OLIN and WSAS conducted postal questionnaire surveys in random samples of adults aged 20 to 75 years. In OLIN, 6519 participated (response rate, 56.4%); in WSAS, 23 753 participated (response rate, 50.1%). MAIN OUTCOMES AND MEASURES Electronic cigarette use, smoking habits, and respiratory symptoms. RESULTS Of 30 272 participants (16 325 women [53.9%]). 3897 (12.9%) were aged 20 to 29 years; 4242 (14.0%). 30 to 39 years; 5082 (16.8%). 40 to 49 years; 6052 (20.0%), 50 to 59 years; 6628 (21.9%), 60 to 69 years; and 4371(14.4%), 70 to 75 years. The number of current smokers was 3694 (12.3%), and 7305 (24.4%) were former smokers. The number of e-cigarette users was 529 (2.0%). and e-cigarette use was more common among men (275 of 12 347 [2.2%; 95% CI, 2.0%-2.5%]) than women (254 of 14 022 [1.8%; 95% CI, 1.6%-2.0%]). Among current smokers. 350 of 3566 (9.8%; 95% CI, 8.8%10.8%) used e-cigarettes compared with 79 of 6875 (1.1%; 95% CI, 0.9%-1.3%) in former smokers and 96 of 15 832 (0.6%; 95% CI, 0.5%-0.7%) in nonsmokers (P < .001). Among e-cigarette users who answered the survey question about cigarette-smoking habits (n = 525). 350 (66.7%; 95% CI, 62.7%-70.7%) were current smokers, 79 (15.0%; 95% CI, 11.9%-18.1%) were former smokers, and 96 (18.3%; 95% CI, 15.0%-21.6%) were nonsmokers (P < .001 for trend). In a regression analysis, e-cigarette use was associated with male sex (odds ratio [OR], 1.35; 95% CI. 1.12-1.62); age groups 20 to 29 years (OR. 2.77; 95% CI, 1.90-4.05), 30 to 39 years (OR, 2.27; 95% CI, 1.53-3.36), 40 to 49 years (OR, 1.65; 95% CI, 1.11-2.44). and 50 to 59 years (OR, 1.47; 95% CI, 1.01-2.12); educational level at primary school (OR, 1.99; 95% CI, 1.51-2.64) and upper secondary school (OR, 1.57; 95% CI, 1.25-1.96); former smoking (OR. 2.37; 95% CI, 1.73-3.24); and current smoking (OR. 18.10; 95% CI, 14.19-23.09). All respiratory symptoms were most common among dual users and former smokers and nonsmokers who used e-cigarettes. CONCLUSIONS AND RELEVANCE Use of e-cigarettes was most common among smokers, and dual users had the highest prevalence of respiratory symptoms. On a population level, this study indicates that the present use of e-cigarettes does not adequately serve as a smoking cessation tool.
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| 2. |
- Jansson, Sven-Arne, et al.
(författare)
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Severe asthma is related to high societal costs and decreased health related quality of life
- 2020
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Ingår i: Respiratory Medicine. - : Elsevier BV. - 0954-6111 .- 1532-3064. ; 162
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of the present study was to estimate the societal costs and the key cost drivers for patients with severe asthma in Sweden. In addition, health-related quality of life (HRQOL) and morbidity of patients with severe asthma is described. Methods: The study population comprised adults with severe asthma recruited from a large asthma cohort within the Obstructive Lung Disease in Northern Sweden (OLIN) studies. During 2017, patients were interviewed quarterly over telephone regarding their resource utilization and productivity losses. Results: Estimated mean annual asthma-related costs per patient with severe asthma amounted to (sic)6,500, of which approximately (sic)2400 and (sic)4100 were direct and indirect costs, respectively. The main cost drivers for direct costs were hospitalizations followed by drugs: approximately (sic)1000 and (sic)800, respectively. Patients on treatment with regular oral corticosteroids (OCS) had greater direct costs compared with those without regular OCS treatment. Co-morbid conditions were common and the costs were substantial also for co-morbid conditions, with a total cost of approximately (sic)4200. The OCS group had significantly lower HRQOL compared to the non-OCS group. Conclusions: The societal costs due to severe asthma were substantial. Costs for co-morbid conditions contributed substantially to both direct and indirect costs. The direct costs were significantly higher in the maintenance OCS-group compared to the non-maintenance OCS-group. These results indicate a need for improved management and treatment regimens for patients with severe asthma.
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| 4. |
- Larsson, K., et al.
(författare)
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Adherence to Treatment Recommendations for Chronic Obstructive Pulmonary Disease - Results from the Swedish National Airway Register
- 2021
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Ingår i: International Journal of Chronic Obstructive Pulmonary Disease. - 1178-2005. ; 16, s. 909-918
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: Swedish guidelines adhere to the international GOLD document regarding management of chronic obstructive pulmonary disease (COPD). Based on data from the Swedish National Airway Register (SNAR) the aim was to evaluate adherence to guidelines of pharmacological treatment of COPD in Swedish primary and secondary care. Methods: During a period of 18 months, data on symptoms (CAT, mMRC), lung function, exacerbation history and pharmacological treatment from 15,595 COPD patients from 853 primary care and 125 secondary care clinics were collected from SNAR. Patients with a co-diagnosis of asthma were excluded. Patients were divided into four treatment groups: no pharmacological treatment, short-acting bronchodilators alone, long-acting bronchodilators alone and ICS alone or in combination with bronchodilators. Results: Of the patients, 29% were in GOLD group A, 58% in group B, 2% in group C and 11% in group D. CAT score was >= 10 and mMRC score was below 2 in 30.9% of the patients and mMRC score was >= 2 and CAT score <10 in 4.2% of the patients. In 61.4% of the patients, no exacerbation was registered during the last year. Long-acting bronchodilators were prescribed for 78% and ICS for 46% of all patients. In groups A, B, C and D, respectively, 21%, 11%, 11% and 5% did not receive any inhaler therapy; 67%, 81%, 81% and 90% received long-acting bronchodilators; 33%, 46%, 55% and 71% received any ICS containing therapy and 19%, 34%, 39% and 61% received triple therapy. Discussion: Data from the SNAR indicate that only a minority of COPD patients were untreated. There was a liberal use of ICS containing drug combinations in subjects who do not have an indication for ICS. A considerable proportion of subjects at high risk of exacerbations did not receive ICS treatment.
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| 5. |
- Lindberg, Anne, et al.
(författare)
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Low nicotine dependence and high self-efficacy can predict smoking cessation independent of the presence of chronic obstructive pulmonary disease: a three year follow up of a population-based study
- 2015
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Ingår i: Tobacco Induced Diseases. - : E.U. European Publishing. - 1617-9625. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD), and smoking cessation is the only intervention that slows disease progression. It is important to know whether current factors related to smoking and smoking cessation are different among subjects with and without COPD in order to support smoking cessation. The aim of this study was to evaluate factors related to smoking cessation and to compare characteristics and nicotine dependence among smokers with and without COPD. Methods: In 2005, 1614 subjects in a population-based longitudinal study of subjects with COPD and controls were examined. The Fagerstrom Test for Nicotine Dependence (FTND) and motivation for smoking cessation were assessed for current smokers (n = 299 total, 194 with COPD). Data on smoking cessation were collected in a follow-up in 2008 (n = 240). Results: Smokers with COPD had more pack-years and respiratory symptoms than smokers without COPD, whereas higher FTND scores were associated with anxiety/depression and respiratory symptoms in both groups. Nineteen percent of the smokers had quit smoking by the follow-up 3 years later, and they had significantly lower FTND scores (2.54 vs. 3.75, p < 0.001) and higher self-efficacy scores (10.0 vs. 6.0, p = 0.020) at baseline than the sustained smokers. Smoking cessation was related to low FTND scores and high self-efficacy independent of the presence of COPD, respiratory symptoms, anxiety/depression, and heart disease. Conclusions: The FTND score and a simple visual analog scale for assessing self-efficacy seem to be valuable instruments for predicting smoking cessation over several years, independent of COPD, respiratory symptoms, presence of anxiety/depression, and heart disease.
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