Understanding the impact of second-hand smoke exposure on clinical outcomes in participants with COPD in the SPIROMICS cohort

Nirupama Putcha; R Graham Barr; Meilan K Han; Prescott G Woodruff; Eugene R Bleecker; Richard E Kanner; Fernando J Martinez; Benjamin M Smith; Donald P Tashkin; Russell P Bowler; Mark D Eisner; Stephen I Rennard; Robert A Wise; Nadia N Hansel; SPIROMICS Investigators

doi:10.1136/thoraxjnl-2015-207487

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Understanding the impact of second-hand smoke exposure on clinical outcomes in participants with COPD in the SPIROMICS cohort

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Understanding the impact of second-hand smoke exposure on clinical outcomes in participants with COPD in the SPIROMICS cohort

Nirupama Putcha, R Graham Barr, Meilan K Han, Prescott G Woodruff, Eugene R Bleecker, Richard E Kanner, Fernando J Martinez, Benjamin M Smith, Donald P Tashkin, Russell P Bowler, …

Thorax, Vol.71(5), pp.411-420

05/2016

DOI: 10.1136/thoraxjnl-2015-207487

PMID: 26962015

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Abstract

BackgroundSecond-hand smoke (SHS) exposure has been linked to the development of and morbidity from lung disease. We sought to advance understanding of the impact of SHS on health-related outcomes in individuals with COPD.MethodsAmong the participants with COPD in SPIROMICS, recent SHS exposure was quantified as (1) hours of reported exposure in the past week or (2) reported living with a smoker. We performed adjusted regression for SHS with outcomes, testing for interactions with gender, race, smoking and obesity.ResultsOf the 1580 participants with COPD, 20% reported living with a smoker and 27% reported exposure in the past week. Living with a smoker was associated with worse St George's Respiratory Questionnaire score (SGRQ, β 3.10; 95% CI 0.99 to 5.21), COPD Assessment Test score (β 1.43; 95% CI 0.52 to 2.35) and increased risk for severe exacerbations (OR 1.51, 95% CI 1.04 to 2.17). SHS exposure in the past week was associated with worse SGRQ (β 2.52; 95% CI 0.47 to 4.58), nocturnal symptoms (OR 1.58; 95% CI 1.19 to 2.10), wheezing (OR 1.34; 95% CI 1.02 to 1.77), chronic productive cough (OR 1.77; 95% CI 1.33 to 2.35) and difficulty with cough and sputum (Ease of Cough and Sputum scale, β 0.84; 95% CI 0.42 to 1.25). SHS was associated with increased airway wall thickness on CT but not emphysema. Active smokers, obese individuals and individuals with less severe airflow obstruction also had higher susceptibility to SHS for some outcomes.ConclusionIndividuals with COPD, including active smokers, have significant SHS exposure, associated with worse outcomes and airway wall thickness. Active smokers and obese individuals may have worse outcomes associated with SHS.Trial registration numberNCT01969344 (clinicaltrials.gov).

Details

Title: Subtitle: Understanding the impact of second-hand smoke exposure on clinical outcomes in participants with COPD in the SPIROMICS cohort
Creators: Nirupama Putcha - Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
R Graham Barr - Columbia University School of Medicine, New York, New York, USA
Meilan K Han - University of Michigan School of Medicine, Ann Arbor, Michigan, USA
Prescott G Woodruff - University of California San Francisco School of Medicine, San Francisco, California, USA
Eugene R Bleecker - Wake Forest University Center for Genomics and Personalized Medicine Research, Winston-Salem, North Carolina, USA
Richard E Kanner - University of Utah Health Sciences Center, Salt Lake City, Utah, USA
Fernando J Martinez - Weill Cornell Medical College, New York City, New York, USA
Benjamin M Smith - Columbia University School of Medicine, New York, New York, USA
Donald P Tashkin - University of California Los Angeles, David Geffen School of Medicine, Los Angeles, California, USA
Russell P Bowler - National Jewish Health, Denver, Colorado, USA
Mark D Eisner - Genentech, Inc., South San Francisco, California, USA
Stephen I Rennard - University of Nebraska Medical Center, Omaha, Nebraska, USA
Robert A Wise - Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
Nadia N Hansel - Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
SPIROMICS Investigators
Contributors: Eric A Hoffman (Contributor) - University of Iowa, Radiology
Resource Type: Journal article
Publication Details: Thorax, Vol.71(5), pp.411-420
DOI: 10.1136/thoraxjnl-2015-207487
PMID: 26962015
ISSN: 0040-6376
eISSN: 1468-3296
Grant note: DOI: 10.13039/100000050, name: National Heart, Lung, and Blood Institute, award: HHSN2682009000019C, HHSN268200900013C, HHSN268200900014C, HHSN268200900015C, HHSN268200900016C, HHSN268200900017C, HHSN268200900018C, HHSN268200900020C
Language: English
Date published: 05/2016
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
Record Identifier: 9984051711402771

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