Difference in Airflow Obstruction between Hispanic and Non-Hispanic White Female Smokers

Abstract

Smoking-related respiratory diseases are a major cause of morbidity and mortality. However, the relationship between smoking and respiratory disease has not been well-studied among ethnic minorities in general and among women in particular. The objective of this cross-sectional study was to evaluate the risk of airflow obstruction and to assess lung function among Hispanic and non-Hispanic White (NHW) female smokers in a New Mexico cohort. Participants completed a questionnaire detailing smoking history and underwent spirometry testing. Outcomes studied included airflow obstruction, selected lung function parameters, and chronic mucus hyper-secretion. Chi square, logistic, and linear regression techniques were utilized. Of the 1,433 eligible women participants, 248 (17.3%) were Hispanic; and 319 had airflow obstruction (22.3%). Hispanic smokers were more likely to be current smokers, and report lower pack-years of smoking, compared to NHW smokers (p < 0.05 for all analyses). Further, Hispanic smokers were at a reduced risk of airflow obstruction compared to NHW smokers, with an O.R. of 0.51, 95% C.I. 0.34, 0.78 (p = 0.002) after adjustment for age, BMI, pack-years and duration of smoking, and current smoking status. Following adjustment for covariates, Hispanic smokers also had a higher mean absolute and percent predicted post-bronchodilator FEV₁/FVC ratio, as well as higher mean percent predicted FEV₁ (p < 0.05 for all analyses). Hispanic female smokers in this New Mexico-based cohort had lower risk of airflow obstruction and better lung function than NHW female smokers. Further, smoking history did not completely explain these associations.

Key words: :

• Hispanic ethnicity
• Smokers
• Airflow obstruction
• Pulmonary function
• Chronic mucus hyper-secretion
• Women

Abbreviations
NHW:	=	Non-Hispanic White;
NHANES III:	=	Third National Health and Nutrition Examination Survey;
BMI:	=	Body mass index;
ATS:	=	American Thoracic Society;
ERS:	=	European Respiratory Society;
FEV1:	=	Forced expiratory volume in 1 second;
FVC:	=	Forced vital capacity;
GOLD:	=	Global Initiative for Chronic Obstructive Lung Disease;
COPD:	=	Chronic Obstructive Pulmonary Disease;
CYP:	=	Cytochromal;
U.S.:	=	United States;
ETS:	=	Environmental tobacco smoke;
AAT:	=	Alpha 1-antitrypsin

Abbreviations
NHW:	=	Non-Hispanic White;
NHANES III:	=	Third National Health and Nutrition Examination Survey;
BMI:	=	Body mass index;
ATS:	=	American Thoracic Society;
ERS:	=	European Respiratory Society;
FEV1:	=	Forced expiratory volume in 1 second;
FVC:	=	Forced vital capacity;
GOLD:	=	Global Initiative for Chronic Obstructive Lung Disease;
COPD:	=	Chronic Obstructive Pulmonary Disease;
CYP:	=	Cytochromal;
U.S.:	=	United States;
ETS:	=	Environmental tobacco smoke;
AAT:	=	Alpha 1-antitrypsin