Abstract：Objective To explore the association between time to first cigarette (TTFC) and expiratory airflow limitation, so as to provide a reference for the prevention and control of pulmonary function decline. Methods Based on the baseline survey of the China Multi-Ethnic Cohort (CMEC), the demographic, lifestyle behavior, smoking behavior, and TTFC data of permanent residents aged 30 to 79 years in Chengdu City were collected from 2018 to 2019. The TTFC was divided into ≤5, 6-30, 31-60, and >60 minutes. Expiratory airflow limitation was determined when the proportion of the measured peak expiratory flow to the predicted value was less than 80%. The association between TTFC and expiratory airflow limitation was analyzed using a multivariable logistic regression model, and subgroup analyses were conducted according to smoking cessation, age of starting smoking, smoking duration, average daily smoking volume, and the habit of deep inhalation into the lungs. Results A total of 6 766 residents were investigated, among whom 6 402 were males, accounting for 94.62%. The median age was 52 (interquartile range, 19) years. A total of 2 468 residents were detected with expiratory airflow limitation, with a detection rate of 36.48%. Multivariable logistic regression analysis showed that after adjusting for demographics, lifestyle behavior, smoking cessation, age of starting smoking, smoking duration, average daily smoking volume, and the habit of deep inhalation into the lungs, TTFC ≤5 minutes (OR=1.203, 95%CI: 1.035-1.397) and 6-30 minutes (OR=1.174, 95%CI: 1.002-1.374) were associated with an increased risk of expiratory airflow limitation. Subgroup analyses showed that there was no interaction between smoking behavior and TTFC on the risk of expiratory airflow limitation (all P>0.05). Conclusion A shorter TTFC is associated with an increased risk of expiratory airflow limitation among residents aged 30 to 79 years, and the association is not affected by snoking behaviors such as smoking cessation, age of starting smoking, smoking duration and average daily smoking volume.
袁韵, 钱雯, 尉芝苗, 魏咏兰, 王亮, 韩明明. 首次吸烟延迟时间与呼气气流受限的关联研究[J]. 预防医学, 2025, 37(9): 922-926.
YUAN Yun, QIAN Wen, YU Zhimiao, WEI Yonglan, WANG Liang, HAN Mingming. Association between time to first cigarette and expiratory airflow limitation. Preventive Medicine, 2025, 37(9): 922-926.
[1] ZHANG Y R,CHENG C,WEI F,et al.Reduced peak expiratory flow predicts increased risk of cardiovascular disease:a 10-year prospective cohort study in Eastern China[J/OL].Respir Med Res,2023[2025-08-22].https://doi.org/10.1016/j.resmer.2022.100988. [2] QUINTERO SANTOFIMIO V,KNOX-BROWN B,POTTS J,et al.Small airways obstruction and mortality:findings from the UK biobank[J].Chest,2024,166(4):712-720. [3] 中华医学会呼吸病学分会肺功能专业组.肺功能检查指南——呼气峰值流量及其变异率检查[J].中华结核和呼吸杂志,2017,40(6):426-430. Pulmonary Function Professional Group of the Respiratory Diseases Branch of the Chinese Medical Association.Guideline for pulmonary function examination:peak expiratory flow and its variability[J].Chin J Tuberc Respir Dis,2017,40(6):426-430.(in Chinese) [4] BURNEY P,PATEL J,MINELLI C,et al.Prevalence and population-attributable risk for chronic airflow obstruction in a large multinational study[J].Am J Respir Crit Care Med,2021,203(11):1353-1365. [5] LIU Z,LI Y H,CUI Z Y,et al.Prevalence of tobacco dependence and associated factors in China:findings from nationwide China Health Literacy Survey during 2018-19[J/OL].Lancet Reg Health West Pac,2022,24[2025-08-22].https://doi.org/10.1016/j.lanwpc.2022.100464. [6] Transdisciplinary Tobacco Use Research Center(TTURC)Tobacco Dependence,BAKER T B,PIPER M E,et al.Time to first cigarette in the morning as an index of ability to quit smoking:implications for nicotine dependence[J].Nicotine Tob Res,2007,9(Suppl. 4):S555-S570. [7] WANG C,JIANG H,ZHU Y,et al.Association of the time to first cigarette and the prevalence of chronic respiratory diseases in Chinese elderly population[J].J Epidemiol,2022,32(9):415-422. [8] 赵星,洪峰,殷建忠,等.西南区域自然人群队列简介与研究进展[J].中华流行病学杂志,2023,44(1):40-47. ZHAO X,HONG F,YIN J Z,et al.Introduction of general population cohort study in southwestern China[J].Chin J Epidemiol,2023,44(1):40-47.(in Chinese) [9] 王昕,吕筠,郭彧,等.中国慢性病前瞻性研究:10个项目地区成年人群吸烟行为特征差异分析[J].中华流行病学杂志,2015,36(11):1200-1204. WANG X,LYU J,GUO Y,et al.Regional differences in adults' smoking pattern:findings from China Kadoorie Biobank study in 10 areas in China[J].Chin J Epidemiol,2015,36(11):1200-1204.(in Chinese) [10] XIA Y,ZHANG H H,CAO L M,et al.Household solid fuel use and peak expiratory flow in middle-aged and older adults in China:a large cohort study(2011-2015)[J/OL].Environ Res,2021,193[2025-08-22].https://doi.org/10.1016/j.envres.2020.110566. [11] SACKS F M,SVETKEY L P,VOLLMER W M,et al.Effects on blood pressure of reduced dietary sodium and the Dietary Approaches to Stop Hypertension (DASH)diet.DASH-Sodium Collaborative Research Group[J].N Engl J Med,2001,344(1):3-10. [12] 国家卫生健康委员会肥胖症诊疗指南编写委员会.肥胖症诊疗指南(2024年版)[J].中国循环杂志,2025,40(1):6-30. National Clinical Practice Guideline on Obesity Management Editorial Committee.National clinical practice guideline on obesity management(2024 edition)[J].Chin Circ J,2025,40(1):6-30.(in Chinese) [13] KIM G,SONG H J,PARK K,et al.Association of time to first morning cigarette and chronic obstructive pulmonary disease measured by spirometry in current smokers[J].Korean J Fam Med,2018,39(2):67-73. [14] BRANSTETTER S A,NYE R T,MUSCAT J E.Time to first cigarette of the day and 4-(methylnitrosamino)-1-2019.104454. [15] BRANSTETTER S A,KREBS N M,CHEN A,et al.Temporal dynamics of smoking urges:investigating morning cravings,nicotine dependence,and smoking behaviors[J].Subst Use Misuse,2025,60(10):1490-1496. [16] LUGG S T,SCOTT A,PAREKH D,et al.Cigarette smoke exposure and alveolar macrophages:mechanisms for lung disease[J].Thorax,2022,77(1):94-101. [17] 黄小倩,罗剑锋,高晶蓉,等.早晨醒来后到吸第一支烟的时间的影响因素分析[J].中国健康教育,2022,38(1):28-33.HUANG X Q,LUO J F,GAO J R,et al.Factors associated with the time to first cigarette after waking up in morning[J].Chin J Health Educ,2022,38(1):28-33.(in Chinese) [18] 赵艳婷,彭柟,刘熹,等.成都市现在吸烟成年人高度烟草依赖状况调查[J].预防医学,2021,33(3):295-298. ZHAO Y T,PENG N,LIU X,et al.High tobacco dependence among adult smokers in Chengdu[J].China Prev Med J,2021,33(3):295-298.(in Chinese) [19] 曹明鑫,杨濮瑞,郭爱敏.慢性阻塞性肺疾病吸烟患者尼古丁依赖的影响因素分析[J].预防医学,2024,36(7):575-579. CAO M X,YANG P R,GUO A M.Influencing factors for nicotine dependence among smoking patients with chronic obstructive pulmonary disease[J].China Prev Med J,2024,36(7):575-579.(in Chinese) [20] CHEN L,XIONG H J,WEN Q R,et al.The role of active and passive smoking in chronic obstructive pulmonary disease and systemic inflammation:a 12-year prospective study in China[J].J Epidemiol Glob Health,2024,14(3):1332-1340.
