Background

Tobacco smoke exposure is a major risk factor for the health of children and adolescents with CF. In this study, we assess whether cessation of smoke exposure is associated with improved outcomes in this population.

Methods

We used annualized and encounter-based data from the U.S. CF Foundation Patient Registry (2006-2018) on all individuals born 1998-2010. The analytical sample included those who ever reported second-hand smoke exposure (daily or weekly), ever lived with a smoker, or ever reported smoking themselves. We used non-linear mixed models for pulmonary exacerbations and linear mixed models for ppFEV₁ and BMI as a function of ceased exposure.

Results

The sample included 3,633 individuals contributing 19,629 person-years. Cessation of smoke exposure reduced the odds of a pulmonary exacerbation in 12 months by 17% (OR 0.83, p < 0.001) in the first year of cessation, with an additional 6% decrease (OR 0.94, p = 0.003) for each additional year of cessation. Cessation was associated with improvements in ppFEV₁ and BMI: 0.7% ppFEV₁ increase (p < 0.001) in the first year of cessation and 0.4% increase (p = 0.001) for each additional year of cessation; 1% increase in BMI percentile (p < 0.001) in the first year of cessation plus 0.4% increase (p = 0.009) for each additional year. Three years of cessation reduce the predicted probability of a pulmonary exacerbation in 12 months by 8% and improve ppFEV₁ and BMI by 2%.

Conclusion

Eliminating smoke exposure may reduce pulmonary exacerbations and improve respiratory and nutritional outcomes in children and adolescents with CF. Both smoking cessation and exposure prevention should be prioritized in pediatric CF care.

中文翻译：

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停止接触烟雾可改善儿科 CF 结果：CF 基金会患者登记数据的纵向分析

背景

烟草烟雾暴露是 CF 儿童和青少年健康的主要风险因素。在这项研究中，我们评估了停止接触烟雾是否与该人群的预后改善有关。

方法

我们使用来自美国 CF 基金会患者登记处 (2006-2018) 的所有 1998-2010 年出生的个体的年度化和基于遭遇的数据。分析样本包括那些曾报告二手烟暴露（每天或每周）、曾与吸烟者同住或曾报告自己吸烟的人。我们对肺部恶化使用非线性混合模型，对 ppFEV ₁和 BMI 使用线性混合模型作为停止暴露的函数。

结果

样本包括 3,633 人，贡献了 19,629 人年。在戒烟的第一年，戒烟后 12 个月内肺部恶化的几率降低了 17%（OR 0.83，p < 0.001），每增加一年又降低了 6%（OR 0.94，p = 0.003）的停止。戒烟与 ppFEV ₁和 BMI 的改善相关：戒烟第一年 ppFEV ₁增加 0.7%（p < 0.001），每多停一年，ppFEV 1 增加 0.4%（p = 0.001）；戒烟第一年 BMI 百分位数增加 1% (p < 0.001)，每增加一年增加 0.4% (p = 0.009)。戒烟 3 年可将 12 个月内肺部恶化的预测概率降低 8% 并提高 ppFEV ₁和 BMI 降低 2%。

结论

消除烟雾暴露可减少 CF 儿童和青少年的肺部恶化并改善呼吸和营养结果。在儿科 CF 护理中应优先考虑戒烟和预防暴露。