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Jung and Jung: Effects of Smoking Status on Chronic Obstructive Pulmonary Disease Prevalence in Males 40 years and Older: Findings from the Korean National Health and Nutrition Examination Survey
Original Article

Korean J Health Promot 2014;14(4):155-161.

Published online: 20 January 2014

DOI: https://doi.org/10.15384/kjhp.2014.14.4.155

Effects of Smoking Status on Chronic Obstructive Pulmonary Disease Prevalence in Males 40 years and Older: Findings from the Korean National Health and Nutrition Examination Survey

In Sook Jung1, In-Kyung Jung2,

1Department of Nursing, Chodang University, Muangun, Korea

2Department of Beauty Art, Honam University, Gwangju, Korea

Corresponding author：In-Kyung Jung, PhD Department of Beauty Art, Honam University, 27 Sangmuminju-ro 6beon-gil, Seo-gu, Gwangju 502-791, Korea Tel: +82-62-370-8291, Fax: +82-62-370-8341 E-mail: jungik@honam.ac.kr

Received 24 August 2014       Accepted 13 November 2014

Copyright © 2014 The Korean Society of Health Promotion and Disease Prevention

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background

This is a study of the prevalence of chronic obstructive pulmonary disease (COPD), which shows high mortality worldwide, and the effects of smoking on COPD by using data from the Korea National Health and Nutrition Examination Survey V.

Methods

FEV1/FEV6<0.73 was used as a diagnostic criterion of COPD. Frequency analysis for prevalence, descriptive statistics for general characteristics and ventilation rate according to age-specifications, and complex sample logistic regression analysis for the effect of smoking on COPD prevalence were used. IBM SPSS Statistics 21 Standard, Complex Samples for Medical Science(Windows) was used for data analysis(α =0.05).

Results

Prevalence of COPD was 11.6±0.5% of Koreans in their forties or over, and 17.5±0.8% in males, and 6.2±0.5% in females. There was significant increase of COPD prevalence with age increment. Before adjusting for age and smoking index(SI), the COPD possibilities of past and current-smokers compared with non-smoking males were (odds ratio [OR] 2.112 [95% confidence interval [CI] 1.551–2.875]) and (OR 1.834 [95% CI 1.319–2.551]) respectively. After adjustments with age and SI, the COPD possibility of current-smoking was 2.099 (1.382–3.188) times higher and for past-smoking was 1.463 (1.012–2.115) times higher than non-smoking. The P-value of each group was significant. The regression coefficients (B) of current-smoking and past-smoking were 0.741 and 0.380 respectively. The prevalence of COPD increased 1.102 (1.090–1.115) times for every 1 year of age increase, and 1.012 (1.007–1.018) times for every 1 SI increase (P<0.001).

Conclusions

After adjusting for age and SI, the prevalence of COPD in smokers was higher than non-smokers. And current-smoking had a higher OR and higher B than past-smoking.

Keywords: Smoking, Chronic obstructive pulmonary disease (COPD), Prevalence

References

1. Chronic Diseases and Health Promotion Department. Burden of COPD. Geneva: World Health Organization;2014. [Accessed September 15, 2014].http://www.who.int/respiratory/COPD/burden/en/.
2. Burney P, Jithoo A, Kato B, Janson C, Mannino D, Nizankowska-Mogilnicka E, et al. Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty―a BOLD analysis. Thorax. 2014; 69(5):465–73.
crossref
3. Yoo KH, Kim YS, Sheen SS, Park JH, Hwang YI, Kim SH. Prevalence of chronic obstructive pulmonary disease in Korea: the fourth Korean National Health and Nutrition Examination Survey, 2008. Respirology. 2011; 16(4):659–65.
crossref
4. Moon HS. Guideline of COPD. Reston: The Korean Academy of Tuberculosis and Respiratory Diseases 2012. [Accessed Mar 15;2014. ].http://www.lungkorea.org/thesis/guide.php.
5. Yoo KH. Education and Quality Control of Pulmonary Function Test and Chest X-ray in the National Health and Nutrition Examination Survey. Reston: The Korean Academy of Tuberculosis and Respiratory Diseases 2012. [Accessed Mar 15;2014. ].https://knhanes.cdc.go.kr/knhanes/index.do.
6. Patel JG, Nagar SP, Dalal AA. Indirect costs in chronic obstructive pulmonary disease: a review of the economic burden on employers and individuals in the United States. Int J Chron Obstruct Pulmon Dis. 2014; 9:289–300.
crossref
7. Lee JO, Choi BS, Lee JS, Jeong JY, Lee HK. Annual changes of lung function in retired worker exposed to inorganic dusts. Tuberc Respir Dis. 2011; 71(5):341–8.
8. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2010: Korea National Health and Nutrition Examination Survey (KNHANES V-1). Cheongwon: Korea Centers for Disease Control and Prevention;2011.
9. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2011: Korea National Health and Nutrition Examination Survey (KNHANES V-2). Cheongwon: Korea Centers for Disease Control and Prevention;2012.
10. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2012: Korea National Health and Nutrition Examination Survey (KNHANES V-3). Cheongwon: Korea Centers for Disease Control and Prevention;2013.
11. Rosa FW, Perez-Padilla R, Camelier A, Nascimento OA, Menezes AM, Jardim JR, et al. Efficacy of the FEV1/FEV6 ratio compared to the FEV1/FVC ratio for the diagnosis of airway obstruction in subjects aged 40 years or over. Braz J Med Biol Res. 2007; 40(12):1615–21.
crossref
12. Hwang YI, Yoo KH, Sheen SS, Park JH, Kim SH, Yoon HI, et al. Prevalence of chronic obstructive pulmonary disease in Korea: The result of forth Korean National Health and Nutrition Examination Survey. Tuberc Respir Dis. 2011; 71(5):328–34.
crossref
13. Hwang YI, Kim CH, Kang HR, Shin T, Park SM, Jang SH, et al. Comparison of the prevalence of chronic obstructive pulmonary disease diagnosed by lower limit of normal and fixed ratio criteria. J Korean Med Sci. 2009; 24(4):621–6.
crossref
14. Tilert T, Dillon C, Paulose-Ram R, Hnizdo E, Doney B. Estimating the U.S. prevalence of chronic obstructive pulmonary disease using pre- and post-bronchodilator spirometry: the National Health and Nutrition Examination Survey (NHANES) 2007–2010. Respir Res. 2013; 14:103.
crossref
15. Chan-Yeung M, Aït-Khaled N, White N, Ip MS, Tan WC. The burden and impact of COPD in Asia and Africa. Int J Tuberc Lung Dis. 2004; 8(1):2–14.
16. Jung YM, Lee H. Chronic obstructive pulmonary disease in Korea: prevalence, risk factors, and quality of life. J Korean Acad Nurs. 2011; 41(2):149–56.
crossref
17. Kim HW, Yoo ST, Song SH, Joo JC. The effect of aging on the pulmonary function of the healthy adults. Korean J Anesthesiol. 1990; 23(6):1021–6.
crossref
18. Hong SC, Lee C, Han JS, Kim WD, Lee KY, Kim SJ, et al. Annual change of peak expiratory flow rate in asthma and COPD. Tuberc Respir Dis. 2012; 72(1):24–9.
crossref
19. Burney P, Jithoo A, Kato B, Janson C, Mannino D, Nizankowska-Mogilnicka E, et al. Chronic obstructive pulmonary disease mortality and prevalence: the associations with smoking and poverty-a BOLD analysis. Thorax. 2014; 69(5):465–73.
crossref
20. Hong YI, Chae EJ, Seo JB, Lee JH, Kim EK, Lee YK, et al. Contributors of the severity of airflow limitation in COPD patients. Tuberc Respir Dis. 2012; 72(1):8–14.
crossref
21. Lee KJ, Shim JJ. Early detection and early treatment of COPD. Korean J Med. 2009; 77(4):415–21.
22. Gershon AS, Khan S, Klein-Geltink J, Wilton D, To T, Crighton EJ, et al. Asthma and chronic obstructive pulmonary disease (COPD) prevalence and health services use in Ontario Métis: a population-based cohort study. PLoS One. 2014; 23:9 (. (4):e95899.
crossref
23. Jang AS, Park SW, Kim DJ, Uh S, Kim YH, Whang HG, et al. Effects of smoking cessation on airflow obstruction and quality of life in asthmatic smokers. Allergy Asthma Immunol Res. 2010; 2(4):254–9.
crossref
24. Evans J, Chen Y, Camp PG, Bowie DM, McRae L. Estimating the prevalence of COPD in Canada: Reported diagnosis versus measured airflow obstruction. Health Rep. 2014; 19:(. (3):3–11.
25. Masuko H, Sakamoto T, Kaneko Y, Iijima H, Naito T, Noguchi E, et al. Lower FEV1 in non-COPD, nonasthmatic subjects: association with smoking, annual decline in FEV1, total IgE levels, and TSLP genotypes. Int J Chron Obstruct Pulmon Dis. 2011; 6:181–9.

Table 1.
Prevalence of chronic obstructive pulmonary disease in KNHANES V
Characteristics Age group (year) Unweighted frequency COPD(FEV1/FEV6<0.73)
 non-COPD(FEV1/FEV6≥0.73)
Estimate±SEa Unweighted frequency Estimate±SEa Unweighted frequency
Total 40 and over 9,281 11.6±0.5 1,057 88.4±0.5 8,224
Male 40–49 1,204 6.3±0.8 72 93.7±0.8 1,132
  50–59 1,197 13.0±1.3 145 87.0±1.3 1,052
  60–69 993 27.1±1.8 262 72.9±1.8 731
  70–79 572 47.0±2.8 245 53.0±2.8 327
  80 and over 34 64.4±8.2 34 35.6±8.2 24
  Total 4,024 17.5±0.8 758 82.5±0.8 3,266
Female 40–49 1,411 2.2±0.5 28 97.8±0.5 1,383
  50–59 1,717 3.8±0.5 66 96.2±0.5 1,651
  60–69 1,304 9.0±1.1 98 91.0±1.1 1,206
  70–79 748 13.3±1.8 88 86.7±1.8 660
  80 and over 77 22.7±5.9 19 77.3±5.9 58
  Total 5,257 6.2±0.5 299 93.8±0.5 4,958

Abbreviations: KNHANES, Korea National Health and Nutrition Examination Survey; COPD, chronic obstructive pulmonary disease FEV1, forced expiratory volume in 1 second; FEV6, forced expiratory volume in 6 seconds; SE, standard error.

a Values are presented N or estimate ±SE (%) unless otherwise indicated.

Table 2.
Respiratory and smoking characteristics of studied groupa
Characteristics Total
 FEV1/FEV6≥0.73
 FEV1/FEV6<0.73
 t/F Pb
Estimates ±SE Unweighted frequency Estimate ±SE Unweighted frequency Estimate ±SE Unweighted frequency
Age, y 54.9±0.2 4,024 53.0±0.2 3,266 63.6±0.6 758 –17.607 <0.001
FVC, L 4.2±0.0 4,024 4.3±0.0 3,266 4.0±0.0 758 7.433 <0.001
FVCp, % 92.1±0.2 4,020 92.3±0.3 3,262 90.7±0.6 758 2.346 0.019
FEV1, L 3.2±0.0 4,024 3.3±0.0 3,266 2.5±0.0 758 26.336 <0.001
FEV1p, % 89.9±0.3 4,020 92.7±0.3 3,262 77.1±0.7 758 21.642 <0.001
FEV1/FVC 0.8±0.0 4,024 0.8±0.0 3,266 0.6±0.0 758 44.168 <0.001
FEV6, L 4.0±0.0 4,024 4.1±0.0 3,266 3.6±0.0 758 12.110 <0.001
FEV1/FEV6 0.8±0.0 4,024 0.8±0.0 3,266 0.7±0.0 758 46.826 <0.001
Smoking duration, y 22.7±0.3 3,918 20.9±0.3 3,182 31.4±0.8 736 –12.845 <0.001
Smoking amount, pack 0.8±0.1 3,924 0.8±0.0 3,188 0.8±0.0 736 –2.519 0.012
Smoking index, pack∗y 21.0±0.4 3,917 19.6±0.4 3,181 28.2±1.0 736 –8.204 <0.001
Smoking status, %             2.227 0.026
 Current-smoking 41.8±1.0 1,449 82.5±1.2 1,162 17.5±1.2 287    
 Past-smoking 44.1±1.0 1,890 80.4±1.1 1,515 19.6±1.1 375    
 Non-smoking 14.1±0.7 600 89.6±1.3 525 10.4±1.3 75    

Abbreviations: FVC, forced vital capacity; FVCp, predicted value of FVC; FEV1, forced expiratory volume in 1 second; FEV1p, predicted value of FEV1; FEV6, forced expiratory volume in 6 seconds; SE, standard error.

a Values are presented N or estimate±SE (%) unless otherwise indicated.

b Calculated by CSGLM (complex sample general linear model).

Table 3.
FEV1/FVC and FEV1/FEV6 by age in males in KNHANES V
Characteristics Unweighted frequency (N) Weighted (%) FEV1/FVCa FEV1/FEV6a
Estimate±SE Pb Estimate±SE Pb
Age group       <0.001   <0.001
 40–49 (A) 1,204 38.3±1.1 0.793±0.002 (A≠B≠C≠D≠E)c 0.810±0.002 (A≠B≠C≠D≠E)c
 50–59 (B) 1,197 31.4±1.0 0.758±0.003   0.786±0.002  
 60–69 (C) 993 17.4±0.7 0.716±0.003   0.758±0.003  
 70–79 (D) 572 11.5±0.6 0.678±0.005   0.727±0.004  
 80-highest (E) 58 1.5±0.3 0.634±0.015   0.688±0.011  
 Total 4,024 100.0        

Abbreviations: KNHANES, Korea National Health and Nutrition Examination Survey; FVC, forced vital capacity; FEV1, forced expiratory volume in 1 second; FEV6, forced expiratory volume in 6 seconds; SE, standard error.

a Values are presented as estimate±SE in liters.

b Calculated by CSGLM (complex sample general linear model).

c Calculated by repeated CSGLM.

Table 4.
Independent risk factors for chronic obstructive pulmonary disease in males in KNHANES V
Clinical variable B SE OR (95% CI) Pa
Smoking status       <0.001
 Current-smoking 0.607 0.168 1.834 (1.319–2.551)  
 Past-smoking 0.748 0.157 2.112 (1.551–2.875)  
 Non-smoking     1.000 (reference)  
Age group       <0.001
 40–49     1.000 (reference)  
 50–59 0.805 0.191 2.236 (1.537–3.252)  
 60–69 1.718 0.167 5.574 (4.018–7.732)  
 70–79 2.588 0.189 13.300 (9.175–19.281)  
 80 and over 3.302 0.389 27.163 (12.649–58.330)  
Smoking duration, y 0.051 0.004 1.052 (1.044–1.061) <0.001
Smoking amount, pack/day 0.199 0.077 1.221 (1.050–1.419) 0.010
Smoking index, pack∗y 0.022 0.002 1.022 (1.017–1.026) <0.001

Abbreviations: KNHANES, Korea National Health and Nutrition Examination Survey; B, coefficient; SE, standard error; OR, odds ratio; CI, confidence interval.

a Calculated by CSLRA (complex sample logistic regression analysis).

Table 5.
Effects of smoking on chronic obstructive pulmonary disease prevalence in males in KNHANES V
Clinical variable Estimate±SE(%) Unweighted N B±SE OR (95% CI) Pa
Total 100.0 3,939      
Smoking status
 Current-smoking 41.8±1.0 1,449 0.741±0.213 2.099 (1.382–3.188) 0.001
 Past-smoking 44.1±1.0 1,890 0.380±0.188 1.463 (1.012–2.115) 0.043
 Non-smoking 14.1±0.7 600   1.000 (reference)  
Age, per 1-year increase     0.097±0.006 1.102 (1.090–1.115) <0.001
SI, per 1-pack∗year increase     0.012±0.003 1.012 (1.007–1.018) <0.001

Abbreviations: KNHANES, Korea National Health and Nutrition Examination Survey; B, coefficient; SE, standard error; OR, odds ratio; CI confidence interval; SI, smoking index as pack∗year.

a Calculated by CSLRA (complex sample logistic regression analysis).

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