Background While heated tobacco products (HTPs) may affect pulmonary function, the evidence supporting the utility of screening for HTP use in clinical settings is insufficient. We examined the association between HTP use and airway obstruction after switching from cigarettes. Method The study subjects were patients aged ≥20 years undergoing surgery from December 2021 to September 2022 who completed spirometry and reported tobacco (cigarette and HTP) use status during the preoperative assessment. Airway obstruction was defined as forced expiratory volume in 1 s to forced vital capacity ratio below the lower limit of normal. Current tobacco use was defined as past-30-day use. Multivariable Poisson regression analysis was performed to examine the associations between HTP use and airway obstruction by adjusting for demographic characteristics, lifetime cigarette smoking (pack-year) and duration of smoking cessation. Results Overall (N=2850, 55.4% women, mean age 62.4), 4.6% and 10.7% reported current HTP use and cigarette smoking, respectively. 16.8% had airway obstruction. Airway obstruction was more common among current HTP-only users (adjusted prevalence ratio (APR)=2.32), current cigarette-only smokers (APR=2.57) and current dual users (APR=2.82) than never-tobacco users. Among current tobacco users (N=398), the prevalence of airway obstruction was not significantly different between HTP-only users and cigarette-only smokers. Among former cigarette smokers (>30-day cigarette quitters) (N=1077), current HTP users had 1.42 times the increased prevalence of airway obstruction than never-HTP users after adjusting for cigarette pack-year; a stronger association was observed when the analysis was restricted to ≥5-year cigarette quitters (N=772) (APR=1.96, vs never HTP users). Conclusion Current HTP use was associated with airway obstruction among patients with cancer who had completely switched from cigarettes even after quitting smoking for a long period. Patients should be routinely screened for HTP use and advised to quit any tobacco. No data are available. The data used in this study is not publicly available due to privacy and confidentiality concerns associated with the use of patients’ data.

中文翻译：

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加热烟草产品的使用与气道阻塞之间的关联：日本的一项单中心观察性研究

背景 虽然加热烟草制品 (HTP) 可能会影响肺功能，但支持在临床环境中筛查 HTP 使用的证据不足。我们研究了戒烟后使用 HTP 与气道阻塞之间的关联。方法 研究对象为2021年12月至2022年9月期间接受手术的年龄≥20岁的患者，他们在术前评估期间完成了肺活量测定并报告了烟草（香烟和HTP）使用状况。气道阻塞定义为1秒内用力呼气量与用力肺活量之比低于正常下限。目前的烟草使用情况被定义为过去 30 天的使用情况。通过调整人口特征、终生吸烟量（包年）和戒烟持续时间，进行多变量泊松回归分析，以检查 HTP 使用与气道阻塞之间的关联。结果 总体而言（N=2850，55.4% 为女性，平均年龄 62.4 岁），4.6% 和 10.7% 的人报告目前使用 HTP 和吸烟。16.8%有气道阻塞。与从不吸烟者相比，当前仅使用 HTP 的吸烟者（调整后患病率 (APR) = 2.32）、当前仅吸烟者 (APR = 2.57) 和当前双重吸烟者 (APR = 2.82) 中气道阻塞更为常见。在当前烟草使用者（N = 398）中，仅使用 HTP 的使用者和仅吸烟者之间气道阻塞的患病率没有显着差异。在前吸烟者（>30天戒烟者）（N = 1077）中，在调整烟包年份后，当前 HTP 使用者的气道阻塞患病率是从不 HTP 使用者的 1.42 倍；当分析仅限于戒烟 5 年以上的人 (N=772) 时，观察到更强的关联性（APR=1.96，与从未使用过 HTP 的人相比）。结论 对于已经完全戒烟的癌症患者，即使在戒烟很长一段时间后，当前 HTP 的使用与气道阻塞有关。应定期筛查患者是否使用 HTP，并建议戒烟。无可用数据。由于与使用患者数据相关的隐私和保密问题，本研究中使用的数据不公开。