Effects of Smoking Status on Chronic Obstructive Pulmonary Disease Prevalence in Males 40 years and Older: Findings from the Korean National Health and Nutrition Examination Survey

Article information

Korean J Health Promot. 2014;14(4):155-161

Publication date (electronic) : 2014 January 20

doi : https://doi.org/10.15384/kjhp.2014.14.4.155

¹Department of Nursing, Chodang University, Muangun, Korea

²Department of Beauty Art, Honam University, Gwangju, Korea

Corresponding author：In-Kyung Jung, PhD Department of Beauty Art, Honam University, 27 Sangmuminju-ro 6beon-gil, Seo-gu, Gwangju 502-791, Korea Tel: +82-62-370-8291, Fax: +82-62-370-8341 E-mail: jungik@honam.ac.kr

Received 2014 August 24; Accepted 2014 November 13.

Abstract

Background

This is a study of the prevalence of chronic obstructive pulmonary disease (COPD), which shows high mortality worldwide, and the effects of smoking on COPD by using data from the Korea National Health and Nutrition Examination Survey V.

Methods

FEV₁/FEV₆<0.73 was used as a diagnostic criterion of COPD. Frequency analysis for prevalence, descriptive statistics for general characteristics and ventilation rate according to age-specifications, and complex sample logistic regression analysis for the effect of smoking on COPD prevalence were used. IBM SPSS Statistics 21 Standard, Complex Samples for Medical Science(Windows) was used for data analysis(α =0.05).

Results

Prevalence of COPD was 11.6±0.5% of Koreans in their forties or over, and 17.5±0.8% in males, and 6.2±0.5% in females. There was significant increase of COPD prevalence with age increment. Before adjusting for age and smoking index(SI), the COPD possibilities of past and current-smokers compared with non-smoking males were (odds ratio [OR] 2.112 [95% confidence interval [CI] 1.551–2.875]) and (OR 1.834 [95% CI 1.319–2.551]) respectively. After adjustments with age and SI, the COPD possibility of current-smoking was 2.099 (1.382–3.188) times higher and for past-smoking was 1.463 (1.012–2.115) times higher than non-smoking. The P-value of each group was significant. The regression coefficients (B) of current-smoking and past-smoking were 0.741 and 0.380 respectively. The prevalence of COPD increased 1.102 (1.090–1.115) times for every 1 year of age increase, and 1.012 (1.007–1.018) times for every 1 SI increase (P<0.001).

Conclusions

After adjusting for age and SI, the prevalence of COPD in smokers was higher than non-smokers. And current-smoking had a higher OR and higher B than past-smoking.

Keywords: Smoking; Chronic obstructive pulmonary disease (COPD); Prevalence

Table 1.

Prevalence of chronic obstructive pulmonary disease in KNHANES V

Table 2.

Respiratory and smoking characteristics of studied group^a

Table 3.

FEV₁/FVC and FEV₁/FEV₆ by age in males in KNHANES V

Table 4.

Independent risk factors for chronic obstructive pulmonary disease in males in KNHANES V

Table 5.

Effects of smoking on chronic obstructive pulmonary disease prevalence in males in KNHANES V

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Table 1.

Prevalence of chronic obstructive pulmonary disease in KNHANES V

Characteristics	Age group (year)	Unweighted frequency	COPD(FEV₁/FEV₆<0.73)		non-COPD(FEV₁/FEV₆≥0.73)
Characteristics	Age group (year)	Unweighted frequency	Estimate±SE^a	Unweighted frequency	Estimate±SE^a	Unweighted frequency
Total	40 and over	9,281	11.6±0.5	1,057	88.4±0.5	8,224
Male	40–49	1,204	6.3±0.8	72	93.7±0.8	1,132
	50–59	1,197	13.0±1.3	145	87.0±1.3	1,052
	60–69	993	27.1±1.8	262	72.9±1.8	731
	70–79	572	47.0±2.8	245	53.0±2.8	327
	80 and over	34	64.4±8.2	34	35.6±8.2	24
	Total	4,024	17.5±0.8	758	82.5±0.8	3,266
Female	40–49	1,411	2.2±0.5	28	97.8±0.5	1,383
	50–59	1,717	3.8±0.5	66	96.2±0.5	1,651
	60–69	1,304	9.0±1.1	98	91.0±1.1	1,206
	70–79	748	13.3±1.8	88	86.7±1.8	660
	80 and over	77	22.7±5.9	19	77.3±5.9	58
	Total	5,257	6.2±0.5	299	93.8±0.5	4,958

Abbreviations: KNHANES, Korea National Health and Nutrition Examination Survey; COPD, chronic obstructive pulmonary disease FEV₁, forced expiratory volume in 1 second; FEV₆, forced expiratory volume in 6 seconds; SE, standard error.

Values are presented N or estimate ±SE (%) unless otherwise indicated.

Table 2.

Respiratory and smoking characteristics of studied group^a

Characteristics	Total		FEV₁/FEV₆≥0.73		FEV₁/FEV₆<0.73		t/F	P^b
Characteristics	Estimates ±SE	Unweighted frequency	Estimate ±SE	Unweighted frequency	Estimate ±SE	Unweighted frequency	t/F	P^b
Age, y	54.9±0.2	4,024	53.0±0.2	3,266	63.6±0.6	758	–17.607	<0.001
FVC, L	4.2±0.0	4,024	4.3±0.0	3,266	4.0±0.0	758	7.433	<0.001
FVCp, %	92.1±0.2	4,020	92.3±0.3	3,262	90.7±0.6	758	2.346	0.019
FEV₁, L	3.2±0.0	4,024	3.3±0.0	3,266	2.5±0.0	758	26.336	<0.001
FEV₁p, %	89.9±0.3	4,020	92.7±0.3	3,262	77.1±0.7	758	21.642	<0.001
FEV₁/FVC	0.8±0.0	4,024	0.8±0.0	3,266	0.6±0.0	758	44.168	<0.001
FEV₆, L	4.0±0.0	4,024	4.1±0.0	3,266	3.6±0.0	758	12.110	<0.001
FEV₁/FEV₆	0.8±0.0	4,024	0.8±0.0	3,266	0.7±0.0	758	46.826	<0.001
Smoking duration, y	22.7±0.3	3,918	20.9±0.3	3,182	31.4±0.8	736	–12.845	<0.001
Smoking amount, pack	0.8±0.1	3,924	0.8±0.0	3,188	0.8±0.0	736	–2.519	0.012
Smoking index, pack∗y	21.0±0.4	3,917	19.6±0.4	3,181	28.2±1.0	736	–8.204	<0.001
Smoking status, %							2.227	0.026
Current-smoking	41.8±1.0	1,449	82.5±1.2	1,162	17.5±1.2	287
Past-smoking	44.1±1.0	1,890	80.4±1.1	1,515	19.6±1.1	375
Non-smoking	14.1±0.7	600	89.6±1.3	525	10.4±1.3	75

Abbreviations: FVC, forced vital capacity; FVCp, predicted value of FVC; FEV₁, forced expiratory volume in 1 second; FEV₁p, predicted value of FEV₁; FEV₆, forced expiratory volume in 6 seconds; SE, standard error.

Values are presented N or estimate±SE (%) unless otherwise indicated.

Calculated by CSGLM (complex sample general linear model).

Table 3.

FEV₁/FVC and FEV₁/FEV₆ by age in males in KNHANES V

Characteristics	Unweighted frequency (N)	Weighted (%)	FEV1/FVC^a		FEV1/FEV6^a
Characteristics	Unweighted frequency (N)	Weighted (%)	Estimate±SE	P^b	Estimate±SE	P^b
Age group				<0.001		<0.001
40–49 (A)	1,204	38.3±1.1	0.793±0.002	(A≠B≠C≠D≠E)^c	0.810±0.002	(A≠B≠C≠D≠E)^c
50–59 (B)	1,197	31.4±1.0	0.758±0.003		0.786±0.002
60–69 (C)	993	17.4±0.7	0.716±0.003		0.758±0.003
70–79 (D)	572	11.5±0.6	0.678±0.005		0.727±0.004
80-highest (E)	58	1.5±0.3	0.634±0.015		0.688±0.011
Total	4,024	100.0

Abbreviations: KNHANES, Korea National Health and Nutrition Examination Survey; FVC, forced vital capacity; FEV₁, forced expiratory volume in 1 second; FEV₆, forced expiratory volume in 6 seconds; SE, standard error.

Values are presented as estimate±SE in liters.

Calculated by CSGLM (complex sample general linear model).

Calculated by repeated CSGLM.

Table 4.

Independent risk factors for chronic obstructive pulmonary disease in males in KNHANES V

Clinical variable	B	SE	OR (95% CI)	P^a
Smoking status				<0.001
Current-smoking	0.607	0.168	1.834 (1.319–2.551)
Past-smoking	0.748	0.157	2.112 (1.551–2.875)
Non-smoking			1.000 (reference)
Age group				<0.001
40–49			1.000 (reference)
50–59	0.805	0.191	2.236 (1.537–3.252)
60–69	1.718	0.167	5.574 (4.018–7.732)
70–79	2.588	0.189	13.300 (9.175–19.281)
80 and over	3.302	0.389	27.163 (12.649–58.330)
Smoking duration, y	0.051	0.004	1.052 (1.044–1.061)	<0.001
Smoking amount, pack/day	0.199	0.077	1.221 (1.050–1.419)	0.010
Smoking index, pack∗y	0.022	0.002	1.022 (1.017–1.026)	<0.001

Abbreviations: KNHANES, Korea National Health and Nutrition Examination Survey; B, coefficient; SE, standard error; OR, odds ratio; CI, confidence interval.

Calculated by CSLRA (complex sample logistic regression analysis).

Table 5.

Effects of smoking on chronic obstructive pulmonary disease prevalence in males in KNHANES V

Clinical variable	Estimate±SE(%)	Unweighted N	B±SE	OR (95% CI)	P^a
Total	100.0	3,939
Smoking status
Current-smoking	41.8±1.0	1,449	0.741±0.213	2.099 (1.382–3.188)	0.001
Past-smoking	44.1±1.0	1,890	0.380±0.188	1.463 (1.012–2.115)	0.043
Non-smoking	14.1±0.7	600		1.000 (reference)
Age, per 1-year increase			0.097±0.006	1.102 (1.090–1.115)	<0.001
SI, per 1-pack∗year increase			0.012±0.003	1.012 (1.007–1.018)	<0.001

Abbreviations: KNHANES, Korea National Health and Nutrition Examination Survey; B, coefficient; SE, standard error; OR, odds ratio; CI confidence interval; SI, smoking index as pack∗year.

Calculated by CSLRA (complex sample logistic regression analysis).