Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Jun;12(3):276-86.
doi: 10.3109/15412555.2014.949001. Epub 2014 Sep 10.

Associations of Self-Reported Cigarette Smoking with Chronic Obstructive Pulmonary Disease and Co-Morbid Chronic Conditions in the United States

Timothy J Cunningham  1 , Earl S Ford, Italia V Rolle, Anne G Wheaton, Janet B Croft
Affiliations

Associations of Self-Reported Cigarette Smoking with Chronic Obstructive Pulmonary Disease and Co-Morbid Chronic Conditions in the United States

Timothy J Cunningham et al. COPD. 2015 Jun.

Abstract

Background: The question of how smoking, COPD, and other chronic diseases are related remains unresolved. Therefore, we examined relationships between smoking, COPD, and 10 other chronic diseases and assessed the prevalence of co-morbid chronic conditions among people with COPD.

Methods: We analyzed cross-sectional data from 405,856 US adults aged 18 years or older in the 2011 Behavioral Risk Factor Surveillance System. We used log-linear regression to estimate prevalence ratios (PRs) and their corresponding 95% confidence intervals (CIs) for these relationships adjusting for age, gender, race/ethnicity, marital status, educational attainment, annual household income, and health insurance coverage.

Results: Overall, 17.5% reported being current cigarette smokers, 6.9% reported having COPD, and 71.2% reported another chronic condition. After age-adjustment, prevalence of COPD was 14.1% (adjusted PR = 3.9; 95% CI: 3.7, 4.1) among current smokers and 7.1% (adjusted PR = 2.5; 95% CI: 2.4, 2.7) among former smokers compared to 2.9% among never smokers. The most common chronic conditions among current smokers after age-adjustment were high cholesterol (36.7%), high blood pressure (34.6%), arthritis (29.4%), depression (27.4%), and asthma (16.9%). In separate multivariable models, smoking and COPD were associated with each of the 10 other chronic conditions (p < 0.05), which also included cancer, coronary heart disease, diabetes, kidney disease, and stroke; COPD modified associations between smoking and co-morbidities, while smoking did not modify associations between COPD and co-morbidities.

Conclusions: Our findings confirm previous evidence and highlight the continuing importance of comprehensive care coordination for people with COPD and co-morbid chronic conditions and also tobacco prevention and control strategies.

Keywords: COPD; chronic disease; cross-sectional studies; smoking; tobacco use.

PubMed Disclaimer

Conflict of interest statement

Declaration of Interest Statement

The authors have no conflicts of interest to report. The authors alone are responsible for the content and writing of the paper.

Figures

Figure 1
Figure 1
Age-adjusted percentages of chronic conditions among adults aged ≥18 years, by cigarette smoking status: Behavioral Risk Factor Surveillance System, 2011.
Figure 2
Figure 2
Age-adjusted percentages of chronic conditions among adults aged ≥18 years, by chronic obstructive pulmonary disease (COPD) status: Behavioral Risk Factor Surveillance System, 2011.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Ford ES, Croft JB, Mannino DM, Wheaton AG, Zhang X, Giles WH. COPD Surveillance-United States, 1999–2011. Chest. 2013 Jul 1;144(1):284–305. - PMC - PubMed
    1. Barr RG, Celli BR, Mannino DM, Petty T, Rennard SI, Sciurba FC, et al. Comorbidities, patient knowledge, and disease management in a national sample of patients with COPD. Ame J Med. 2009 Apr;122(4):348–355. - PMC - PubMed
    1. Cazzola M, Bettoncelli G, Sessa E, Cricelli C, Biscione G. Prevalence of comorbidities in patients with chronic obstructive pulmonary disease. Respir Inter Rev Thorac Dis. 2010;80(2):112–119. - PubMed
    1. Corsonello A, Antonelli Incalzi R, Pistelli R, Pedone C, Bustacchini S, Lattanzio F. Comorbidities of chronic obstructive pulmonary disease. Curr Opin Pulmon Med. 2011 Dec;17( Suppl 1):S21–28. - PubMed
    1. Corsonello A, Pedone C, Incalzi RA. Comorbidities and risk assessment in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2012 Oct 15;186(8):804. author reply 5. - PubMed

MeSH terms