Abstract
Background: COPD risk is lower in black (OR 0.44; 0.39 - 0.51) and Asian people (0.82; 0.68 - 0.98) than white people, when adjusting for age, sex, deprivation and smoking status. The role of smoking intensity was assessed in these ethnic differences.
Methods: Primary care data from inner London were used for this retrospective, cross-sectional study. Mean cigarettes per day (CPD) was compared between ethnic groups. COPD risk was compared between ethnic groups using multiple logistic regression, controlling for age, sex, deprivation, and either smoking status (never, current, ex-smoker) or smoking intensity (never, light, moderate, heavy smoker).
Results: 1,000,388 over-18s were included. 82% of current smokers and 33% of ex-smokers had CPD recorded. Adjusted mean CPD was lower in black (7.0; 7.0 - 7.1) and Asian smokers (7.2; 7.1 - 7.2) than white smokers (10.3; 10.3 - 10.3).
Ethnicity | (i) Odds ratio (95% CI) controlling for smoking status (never, current, ex-smoker) (n=854,950) | (ii) Odds ratio (95% CI) controlling for smoking intensity (never, light, moderate, heavy smoker) (n=717,253) |
White | 1 | 1 |
Black | 0.42 (0.39-0.45) | 0.43 (0.40-0.48) |
Asian | 0.77 (0.73-0.82) | 0.74 (0.68-0.81) |
Mixed | 0.58 (0.51-0.67) | 0.63 (0.53-0.75) |
Chinese | 0.52 (0.46-0.59) | 0.52 (0.45-0.60) |
Discussion: COPD risk is lower in all minority ethnic groups in London. Ethnic minority smokers in London are lighter smokers than white smokers. Adjusting for smoking intensity rather than smoking status did not significantly affect ethnic COPD risk. Ethnic differences in COPD prevalence are not explained by ethnic differences in smoking intensity.
- Copyright ©the authors 2016