Sigara kullanımı ile kronik solunumsal semptomlar ,gelir ve eğitim düzeyi arasındaki ilişkinin analizi

Yıl 2020, Cilt: 10 Sayı: 1, 35 - 39, 31.03.2020

Tarkan Özdemir , Benan Kasapoğlu , İbrahim Akkuş , Ferit Kaya , Edibe Pirinçci , Semiha Eren , Mustafa Hamidullah Türkkanı , Çiğdem Özdilekcan , İrem Bulut

https://doi.org/10.16899/jcm.658655

Cited By: 2

Öz

Amaç :Bu çalışmada sigara içenlerin genel demografik karakterlerini belirlemeyi ve sigara içme ile solunumsal belirtiler, eğitim ve gelir düzeyi arasındaki ilişkiyi tanımlamayı amaçladık.
Gereç ve Yöntemler: 40 yaş ve üzeri 1019 kişinin dahil edildiği prospektif bir çalışma planlandı. Tüm katılımcılara solunumsal belirtiler, tütün kullanımı ve kronik solunum hastalığı ile ilişkili risk faktörlerini sorgulayan bir anket yapıldı. Çalışma katılımcıları sigara içme durumlarına göre halen içenler ,hiç içmeyenler ve sigarayı bırakmış olanlar şeklinde gruplandırıldı.Yaş, cinsiyet, evlilik durumu, eğitim seviyesi ve kişi başı aylık gelir düzeyi tüm katılımcılar için kaydedildi.
Bulgular: Ortalama yaşı 53.20 ±9.06 (range: 40-90 yıl) olan 1019 kişi çalışmaya dahil edildi. Kadınlar arasında 72/486 erkekler arasında 226/533 kişi aktif sigara içicisiydi (p:0.001). Orta okul-lise ve üniversite mezunları daha fazla sıklıkla sigara içiyor veya sigarayı bırakmıştı. 3 aydan daha uzun süren öksürük ve balgam katılımcıların 66’sında (%6.5) tespit edilmişken, 3 aydan uzun süren öksürük, balgam, nefes darlığı bir triad olarak katılımcıların 36’sında (%3.5) tespit edildi. Bu hasta gurupları arasında sigara kullananların oranı belirgin olarak yüksekti. Kronik akciğer hastalığı düşündüren semptomları olan hastaların önemli bir kısmının (% 63.8) daha önce herhangi bir kronik solunum hastalığı tanısı yoktu.
Sonuç: Önceki raporların aksine, eğitimli ve daha yüksek aylık gelirlilerde daha fazla sigara içildiğini tespit ettik. Ayrıca kronik solunumsal hastalıklarının yeterince teşhis edilemediğini bulduk. Kronik akciğer hastalıklarının erken teşhisi için yapılacak taramalarda hedef populasyonun seçimi için semptomatik sorgulamanın halen önemli olduğunu düşünüyoruz.

Anahtar Kelimeler

KOAH, tütün kullanımı, sosyo-kültürel durum, erken tanı

Analysis of the relationship between smoking and chronic respiratory symptoms, level of income and education

Öz

Objective: In this study, we aimed to determine the general demographic characteristics of smokers and to define the association of smoking with respiratory symptoms, level of education and income.
Materials and Methods: This prospective study was conducted on 1019 people aged 40 and over. A questionnaire containing questions about respiratory symptoms, tobacco use and risk factors for chronic respiratory diseases was applied to all the participants. The study participants were grouped regarding their smoking status as current smokers, never smokers and former smokers. Age, gender, marital status, education level, monthly income per house person were recorded for all participants.
Results: 1019 people with a mean age of 53.20 ±9.06 years (range: 40-90 years) were included in the study. Among females, 72/486 were active smoker; while in males 226/533 were active smoker (p:0.001). Mid- high school and university graduates were more commonly smoker or former-smoker. Participants with higher monthly income per house person (> 1000 TRY) were significantly more commonly active-smoker. Cough and sputum for longer than 3 months was determined in 66 (6.5%) people while the triad of cough and sputum for longer than 3 months and dyspnea was determined in 36 (3.5%) people. Among those participants the ratio of smokers was significantly higher. A significant proportion of participants (63.8%) with the symptoms predicting chronic pulmonary diseases, were not having diagnosis of any chronic respiratory disease before.
Conclusion: We determined that; unlike the previous reports educated and higher monthly income people were more commonly smoker. We also found that chronic respiratory diseases is not sufficiently diagnosed. In screening for early diagnosis of chronic pulmonary diseases, we think that symptomatic interrogation is still important for selection of target population.

Anahtar Kelimeler

tobacco use, socio-cultural situation, early diagnosis, Chronic pulmonary diseases

Kaynakça

• 1. Kõks G, Fischer K, Kõks S. Smoking-related general and cause-specific mortality in Estonia. BMC Public Health. 2017 Jul 19;18(1):34.
• 2. Forey BA, Thornton AJ, Lee PN. Systematic review with meta-analysis of the epidemiological evidence relatingsmoking to COPD, chronic bronchitis and emphysema. BMC Pulm Med. 2011 Jun 14;11:36.
• 3. Alam DS, Jha P, Ramasundarahettige C, Streatfield PK, Niessen LW, Chowdhury MA, et al. Smoking-attributable mortality in Bangladesh: proportional mortality study. Bull World Health Organ. 2013 Oct 1; 91(10):757-64.
• 4. WHO: MPOWER: a policy package to reverse the tobacco epidemic. In. Geneva; 2011[cited 29 Dec 2018]. Available from: http://apps.who.int/iris/handle/10665/43888
• 5. Papadakis S, Cole AG, Reid RD, Coja M, Aitken D, Mullen KA, et al. Increasing Rates of Tobacco Treatment Delivery in Primary Care Practice: Evaluation of the Ottawa Model for Smoking Cessation.Ann Fam Med. 2016 May;14(3):235-43.
• 6. Vestbo J, Hurd SS, Agusti AG, Jones PW, Vogelmeier C, Anzueto A, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med 2013; 187(4): 347–65.
• 7. Medbo A, Melbye H. What role may symptoms play in the diagnosis of airflow limitation? A study in an elderly population. Scand J Prim Health Care 2008; 26(2): 92–8.
• 8. Stanley AJ, Hasan I, Crockett AJ, van Schayck OC, Zvar NA. COPD Diagnostic Questionnaire (CDQ) for selecting at-risk patients for spirometry: a cross-sectional study in Australian general practice. NPJ Prim Care Respir Med 2014; 24(1): 14024.
• 9. WHO: WHO report on the global tobacco epidemic, 2011: warning about the dangers of tobacco. In. Geneva: World Health Organization; 2011[cited 29 Dec 2018]. Available from: https://www.who.int/tobacco/global_report/2011/en/
• 10. Pampel F, Legleye S, Goffette C, Piontek D, Kraus L, Khlat M. Cohort changes in educational disparities in smoking: France, Germany and the United States. Soc Sci Med. 2015 Feb;127:41-50.
• 11. Gironés Sarrió R, Torregrosa MD, López P, Gómez-Codina J, Rosell R. Smoking habits in elderly lung cancer patients: still no changes in epidemiology? A single-center experience. Clin Transl Oncol. 2010 Oct;12(10):686-91.
• 12. Rabe KF, Hurd S, Anzueto A, Barnes PJ, Buist SA, Calverley P, et al. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary. Am J Respir Crit Care Med, 176 (2007), pp. 532-55.
• 13. Sultana P, Akter S, Rahman MM, Alam MS. Prevalence and Predictors of Current Tobacco Smoking in Bangladesh. J Biostatistics and Biometrics App. 2015:1(1).
• 14. Alosaimi FD, Abalhassan M, Alhaddad B, Fallata EO, Alhabbad A, Alshenqiti R, et al. Gender differences and risk factors for smoking among patients with various psychiatric disorders in Saudi Arabia: a cross-sectional study.Int J Ment Health Syst. 2018 May 3;12:21.
• 15. Kim Y, Cho WK. Factors Associated with Successful Smoking Cessation in Korean Adult Males: Findings from a National Survey. Iran J Public Health. 2014 Nov;43(11):1486-96.
• 16. Audrain-McGovern J, Benowitz NL. Cigarette smoking, nicotine, and body weight. Clin Pharmacol Ther. 2011;90(1):164–8.
• 17. Munafo MR, Tilling K, Ben-Shlomo Y. Smoking status and body mass index: a longitudinal study. Nicotine Tob Res. 2009;11(6):765–71.
• 18. Legleye S, Khlat M, Beck F, Peretti-Watel P. Widening inequalities in smoking initiation and cessation patterns: A cohort and gender analysis in France. Drug Alcohol Depend. 2011a;117:233–241.
• 19. Peretti-Watel P, Seror V, Constance J, Beck F. Poverty as a smoking trap. Int J Drug Policy. 2009 May;20(3):230–6.
• 20. Tashkin DP, Murray RP Smoking cessation in chronic obstructive pulmonary disease.Respir Med. 2009 Jul; 103(7):963-74.
• 21. Jha P, Ramasundarahettige C, Landsman V, Rostron B, Thun M, Anderson RN, et al. 21st-century hazards of smoking and benefits of cessation in the United States.N Engl J Med. 2013 Jan 24; 368(4):341-50.
• 22. Fell AKM, Svendsen MV, Kim JL, Abrahamsen R, Henneberger PK, Torén K, et al. Exposure to second-hand tobacco smoke and respiratory symptoms in non-smoking adults: cross-sectional data from the general population of Telemark, Norway.BMC Public Health. 2018 Jul 6;18(1):843.