The association between combustible/electronic cigarette use and stroke based on national health and nutrition examination survey
Abstract Aims This study aims to analyze the association between combustible/electronic cigarettes and the risk of stroke. Methods We obtained data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES). The stroke history and combustible/electronic cigarette use were acquired...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-04-01
|
| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-023-15371-x |
| _version_ | 1797845726596694016 |
|---|---|
| author | Jing Shi Lijun Xiong Jun Guo Yan Yang |
| author_facet | Jing Shi Lijun Xiong Jun Guo Yan Yang |
| author_sort | Jing Shi |
| collection | DOAJ |
| description | Abstract Aims This study aims to analyze the association between combustible/electronic cigarettes and the risk of stroke. Methods We obtained data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES). The stroke history and combustible/electronic cigarette use were acquired by questionnaires. Considering the sole or dual use of combustible cigarettes and electronic cigarettes (e-cigarettes), we divided all the individuals into four subgroups, including nonsmokers (reference group), sole combustible cigarette, sole e-cigarette, and dual use of both combustible cigarettes and e-cigarettes. We performed multivariable logistic regression to determine the association between cigarette use with the prevalence of stroke. We used odds ratios (ORs) with 95% confidence intervals (CIs) to show the effect size. Finally, we developed a prediction model to evaluate the risk of stroke for individuals with combustible or electronic cigarette use based on a random forest model. Results We included a total of 4022 participants in the study. The median age was 55, and 48.3% of the participants were males. When we adjusted for age, gender, education attainment, race, total-to-HDL cholesterol (< 5.9 or ≥ 5.9), diabetes, hypertension, and alcohol consumption, the groups of sole e-cigarette use, sole combustible cigarette use, and dual use of combustible and electronic cigarettes were significantly associated with the prevalence of stroke with ORs (with 95%CI) of 2.07 (1.04–3.81), 2.36 (1.52–3.59), 2.34 (1.44–3.68), respectively. In the testing set, the AUC was 0.74 (95%CI = 0.65–0.84), sensitivity was 0.68, and specificity was 0.75. Conclusion Sole e-cigarettes and dual use of e-cigarettes with combustible cigarettes might increase the risk of stroke. |
| first_indexed | 2024-04-09T17:43:37Z |
| format | Article |
| id | doaj.art-2742915ae6584b7e9aa0603fabe1be78 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-04-09T17:43:37Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-2742915ae6584b7e9aa0603fabe1be782023-04-16T11:27:22ZengBMCBMC Public Health1471-24582023-04-012311710.1186/s12889-023-15371-xThe association between combustible/electronic cigarette use and stroke based on national health and nutrition examination surveyJing Shi0Lijun Xiong1Jun Guo2Yan Yang3Health Management Center, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and TechnologyHealth Management Center, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and TechnologyHealth Management Center, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and TechnologyDepartment of Neurology, Tongji Medical College, The Central Hospital of Wuhan, Huazhong University of Science and TechnologyAbstract Aims This study aims to analyze the association between combustible/electronic cigarettes and the risk of stroke. Methods We obtained data from the 2017–2018 National Health and Nutrition Examination Survey (NHANES). The stroke history and combustible/electronic cigarette use were acquired by questionnaires. Considering the sole or dual use of combustible cigarettes and electronic cigarettes (e-cigarettes), we divided all the individuals into four subgroups, including nonsmokers (reference group), sole combustible cigarette, sole e-cigarette, and dual use of both combustible cigarettes and e-cigarettes. We performed multivariable logistic regression to determine the association between cigarette use with the prevalence of stroke. We used odds ratios (ORs) with 95% confidence intervals (CIs) to show the effect size. Finally, we developed a prediction model to evaluate the risk of stroke for individuals with combustible or electronic cigarette use based on a random forest model. Results We included a total of 4022 participants in the study. The median age was 55, and 48.3% of the participants were males. When we adjusted for age, gender, education attainment, race, total-to-HDL cholesterol (< 5.9 or ≥ 5.9), diabetes, hypertension, and alcohol consumption, the groups of sole e-cigarette use, sole combustible cigarette use, and dual use of combustible and electronic cigarettes were significantly associated with the prevalence of stroke with ORs (with 95%CI) of 2.07 (1.04–3.81), 2.36 (1.52–3.59), 2.34 (1.44–3.68), respectively. In the testing set, the AUC was 0.74 (95%CI = 0.65–0.84), sensitivity was 0.68, and specificity was 0.75. Conclusion Sole e-cigarettes and dual use of e-cigarettes with combustible cigarettes might increase the risk of stroke.https://doi.org/10.1186/s12889-023-15371-xStrokeCombustible cigaretteElectronic cigaretteSmokingClinical prediction model. |
| spellingShingle | Jing Shi Lijun Xiong Jun Guo Yan Yang The association between combustible/electronic cigarette use and stroke based on national health and nutrition examination survey BMC Public Health Stroke Combustible cigarette Electronic cigarette Smoking Clinical prediction model. |
| title | The association between combustible/electronic cigarette use and stroke based on national health and nutrition examination survey |
| title_full | The association between combustible/electronic cigarette use and stroke based on national health and nutrition examination survey |
| title_fullStr | The association between combustible/electronic cigarette use and stroke based on national health and nutrition examination survey |
| title_full_unstemmed | The association between combustible/electronic cigarette use and stroke based on national health and nutrition examination survey |
| title_short | The association between combustible/electronic cigarette use and stroke based on national health and nutrition examination survey |
| title_sort | association between combustible electronic cigarette use and stroke based on national health and nutrition examination survey |
| topic | Stroke Combustible cigarette Electronic cigarette Smoking Clinical prediction model. |
| url | https://doi.org/10.1186/s12889-023-15371-x |
| work_keys_str_mv | AT jingshi theassociationbetweencombustibleelectroniccigaretteuseandstrokebasedonnationalhealthandnutritionexaminationsurvey AT lijunxiong theassociationbetweencombustibleelectroniccigaretteuseandstrokebasedonnationalhealthandnutritionexaminationsurvey AT junguo theassociationbetweencombustibleelectroniccigaretteuseandstrokebasedonnationalhealthandnutritionexaminationsurvey AT yanyang theassociationbetweencombustibleelectroniccigaretteuseandstrokebasedonnationalhealthandnutritionexaminationsurvey AT jingshi associationbetweencombustibleelectroniccigaretteuseandstrokebasedonnationalhealthandnutritionexaminationsurvey AT lijunxiong associationbetweencombustibleelectroniccigaretteuseandstrokebasedonnationalhealthandnutritionexaminationsurvey AT junguo associationbetweencombustibleelectroniccigaretteuseandstrokebasedonnationalhealthandnutritionexaminationsurvey AT yanyang associationbetweencombustibleelectroniccigaretteuseandstrokebasedonnationalhealthandnutritionexaminationsurvey |