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dc.contributor.authorGilkes, A
dc.contributor.authorHull, S
dc.contributor.authorDurbaba, S
dc.contributor.authorSchofield, P
dc.contributor.authorAshworth, M
dc.contributor.authorMathur, R
dc.contributor.authorWhite, P
dc.identifier.citationnpj Primary Care Respiratory Medicine 27, Article number: 50 (2017) doi:10.1038/s41533-017-0052-8en_US
dc.description.abstractChronic obstructive pulmonary disease risk is lower in black and south Asian people than white people, when adjusting for age, sex, deprivation and smoking status. The role of smoking intensity was assessed for its contribution to ethnic differences in chronic obstructive pulmonary disease risk, a relationship not previously investigated. This cross-sectional study included routinely collected primary care data from four multi-ethnic London boroughs. Smoking intensity (estimated by cigarettes per day) was compared between ethnic groups. Chronic obstructive pulmonary disease risk was compared between ethnic groups using multiple logistic regression, controlling for age, sex, deprivation, asthma and both smoking status and smoking intensity, examined independently. In all, 1,000,388 adults were included. Smoking prevalence and intensity were significantly higher in the white British/Irish groups than other ethnic groups. Higher smoking intensity was associated with higher chronic obstructive pulmonary disease risk. Chronic obstructive pulmonary disease risk was significantly lower in all ethnic groups compared with white British/Irish after adjustment for either smoking status or smoking intensity, with lowest risk in black Africans (odds ratio 0.33; confidence interval 0.28-0.38). Ethnic differences in chronic obstructive pulmonary disease risk were not explained in this study by ethnic differences in smoking prevalence or smoking intensity. Other causes of ethnic differences in chronic obstructive pulmonary disease risk should be sought, including ethnic differences in smoking behaviour, environmental factors, repeated respiratory infections, immigrant status, metabolism and addictiveness of nicotine and differential susceptibility to the noxious effects of cigarette smoke.COPD: SMOKING INTENSITY NOT BEHIND ETHNIC DIFFERENCES IN DISEASE RISK: Lower smoking intensity among blacks and south Asians does not explain their lower risk for chronic obstructive pulmonary disease (COPD). A UK team led by Alexander Gilkes from Kings College London analysed primary care data from more than a million people living in four multi-ethnic boroughs of the British capital. The researchers found that smoking status and intensity (as measured by number of cigarettes smoked per day) were both significantly higher in white British or Irish groups than in other ethnic populations. Even after statistically adjusting for smoking status or smoking intensity, however, the researchers couldn't account for the fact that people of south Asian or African descent had much lower prevalence rates of COPD, a lung disease linked to smoking. The findings suggest that other explanations of ethnic differences are still needed.en_US
dc.description.sponsorshipA.G. was in receipt of an NIHR In-Practice Fellowship while completing this work. S.H. and R.M. were supported by a Curriers’ Company Millennium Healthcare Bursary. P.S. was supported by a UK Medical Research Council fellowshipen_US
dc.format.extent50 - ?
dc.publisherNature Publishing Groupen_US
dc.relation.ispartofNPJ Prim Care Respir Med
dc.rightsThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons. org/licenses/by/4.0/.
dc.titleEthnic differences in smoking intensity and COPD risk: an observational study in primary care.en_US
dc.rights.holder© The Author(s) 2017.
pubs.organisational-group/Queen Mary University of London
pubs.organisational-group/Queen Mary University of London/Faculty of Medicine & Dentistry
pubs.organisational-group/Queen Mary University of London/Faculty of Medicine & Dentistry/Blizard Institute
pubs.organisational-group/Queen Mary University of London/Faculty of Medicine & Dentistry/Blizard Institute/Centre for Primary Care and Public Health
pubs.publication-statusPublished online

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