Time to First Morning Cigarette and Risk of Chronic Obstructive Pulmonary Disease: Smokers in the PLCO Cancer Screening Trial

Abstract

BackgroundTime to first cigarette (TTFC) after waking is an indicator of nicotine dependence. The association between TTFC and chronic obstructive pulmonary disease (COPD), the third leading cause of death in the United States, has not yet been reported.MethodsWe investigated the cross-sectional association between TTFC and prevalent COPD among 6,108 current smokers in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. COPD was defined as a self-reported diagnosis of emphysema, chronic bronchitis, or both. Current smokers in PLCO reported TTFC, the amount of time they typically waited before smoking their first cigarette of the day after waking, in four categories: ≤5, 6-30, 31-60, or >60 minutes. We used logistic regression models to investigate the association between TTFC and prevalent COPD with adjustments for age, gender, race, education, and smoking (cigarettes/day, years smoked during lifetime, pack-years, age at smoking initiation), and prior lung cancer diagnosis.ResultsCOPD was reported by 19% of these 6,108 smokers. Individuals with the shortest TTFC had the greatest risk of COPD; compared to those with the longest TTFC (>60 minutes) the adjusted odds ratios (OR) and 95% confidence intervals (CI) for COPD were 1.48 (95% CI, 1.15-1.91), 1.64 (95% CI, 1.29-2.08), 2.18 (95% CI, 1.65-2.87) for those with TTFC 31-60 minutes, 6-30 minutes, and ≤5 minutes, respectively (P-trend <0.0001). The association between TTFC and emphysema was similar to that for bronchitis, albeit the ORs were slightly stronger for chronic bronchitis; comparing TTFC ≤5 minutes to >60 minutes, the adjusted OR (95% CI) was 2.29 (1.69-3.12) for emphysema and 2.99 (1.95-4.59) for chronic bronchitis.ConclusionsCurrent smokers with shorter TTFC have increased risk of COPD compared to those with longer TTFC, even after comprehensive adjustment for established smoking covariates. Future epidemiologic studies, including prospective designs, should incorporate TTFC to better assess disease risk and evaluate the potential utility of TTFC as a COPD screening tool for smokers in the clinical setting.

CYP2A6 metabolism in the development of smoking behaviors in young adults

“…Little consensus exists on the best measure of nicotine dependence, but research supports that two items from the FTND score, time to first cigarette after waking and cigarettes smoked per day, are strong, valid, reliable predictors of quitting behaviors, which are key indicators of dependence (Baker et al, 2007; Borland et al, 2010; Hyland et al, 2006). Studies also suggest that these two measures are distinct predictors of addiction (Borland et al, 2010; Lessov et al, 2004), chronic obstructive pulmonary disease (Guertin et al, 2015), and lung cancer (Gu et al, 2014), suggesting the possibility that different genetic factors may contribute to urgency to smoke and levels of cigarette consumption. In a sample of over 1000 young adults, Haberstick et al (2007) found that time to first cigarette was the most informative measure of heritable factors from the FTND score.…”

Expanding the Genetic Architecture of Nicotine Dependence and its Shared Genetics with Multiple Traits: Findings from the Nicotine Dependence GenOmics (iNDiGO) Consortium

“…6 A more complete understanding of the genetics underlying ND is needed, as it could help to predict the likelihood of quitting smoking, withdrawal severity, response to treatment, and health-related consequences. [7][8][9][10] The Fagerström Test for ND (FTND), also called the Fagerström Test for Cigarette Dependence, 11 provides a composite phenotype that captures multiple behavioral and psychological features of ND among smokers. 12 While CPD is associated with key markers of ND, such as cessation likelihood 13 , the FTND conveys additional valuable information by including 5 items in addition to CPD.…”

Effects of whole body vibration exercises on functional parameters of individuals with chronic obstructive pulmonary disease

“…Eliane O. Guedes-Aguiar, 1,3,6 Cintia R. Sousa-Gonçalves, 2,3 Laisa L. Paineiras-Domingos, 2,3,6 Eloá Moreira-Marconi, 3,4 Danúbia C. Sá-Caputo, 2,3,6,7 Márcia C. Moura-Fernandes, 3,4 Rogério Rufino, 8 Cláudia Henrique Costa, 8 Redha Taiar 5,3 Mario Bernardo-Filho 3 e o potencial de exacerbação da doença. Metodologia: Indivíduos com diagnóstico de DPOC, com idade ≥ 40 anos, serão distribuídos randomicamente em 4 grupos: grupo controle (GC) que não será submetido aos EVCI, grupo submetido aos EVCI na posição sentada 1 vez por semana (GS1) e 2 vezes por semana (GS2) e grupo submetido aos EVCI na posição agachada 2 vezes por semana (GP2).…”

“…COPD is a chronic inflammatory condition of the airways 1 and one of the major causes of morbidity and mortality in the world. [2][3][4] The reduction of the pulmonary function is an important predictor for this cause, 2,5 and, it is associated with acute attacks such as increased cough, dyspnea and purulent sputum. 6,7 According to the 2010 Global Burden of Disease (GBD) study, COPD was responsible for about 5% of global disability and 5% of total deaths (2.9 million).…”

“…9 Due to its chronic nature and its prevalence, it also results in several other related systemic manifestations, such as exercise intolerance, 10 peripheral muscle dysfunction, 11,12 dyspnea, recurrent acute and severe exacerbations, and the need for chronic pulmonary therapy, leading to hospitalization and resulting in impairment on the quality of life. 12,13 Moreover, muscle weakness contributes to exercise intolerance 8 which may contribute to the severity of the disease, 4,9 generating high costs for the health system worldwide 3,4 The treatment program conventionally used for individuals with COPD is pulmonary rehabilitation (PR). 14 The goal of this intervention program is to improve physical performance and reduce dyspnea to prolong the life of individuals with COPD.…”