Contribution of Chronic Conditions to the Disability Burden across Smoking Categories in Middle-Aged Adults, Belgium

IntroductionSmoking is considered the single most important preventable cause of morbidity and mortality worldwide, contributing to increased incidence and severity of disabling conditions. The aim of this study was to assess the contribution of chronic conditions to the disability burden across smoking categories in middle-aged adults in Belgium.MethodsData from 10,224 individuals aged 40 to 60 years who participated in the 1997, 2001, 2004, or 2008 Health Interview Surveys in Belgium were used. Smoking status was defined as never, former (cessation ≥2 years), former (cessation ResultsAn increasing trend in the disability prevalence was observed across smoking categories in men (never = 4.8%, former (cessation ≥2 years) = 5.8%, daily light = 7.8%, daily heavy = 10.7%) and women (never = 7.6%, former (cessation ≥2 years) = 8.0%, daily light = 10.2%, daily heavy = 12.0%). Musculoskeletal conditions showed a substantial contribution to the disability burden in men and women across all smoking categories. Other important contributors were depression and cardiovascular diseases in never smokers; depression, chronic respiratory diseases, and diabetes in former smokers (cessation ≥2 years); chronic respiratory diseases, cancer, and cardiovascular diseases in daily light smokers; cardiovascular diseases and chronic respiratory diseases in men and depression and diabetes in women daily heavy smokers.ConclusionsBeyond the well-known effect of smoking on mortality, our findings showed an increasing trend of the disability prevalence and different contributors to the disability burden across smoking categories. This information can be useful from a public health perspective to define strategies to reduce disability in Belgium.## 引言 吸烟被认为是全球范围内可预防的发病与死亡的单一最重要危险因素，可升高致残性疾病的发病率并加重其严重程度。本研究旨在评估比利时中年人群中，不同吸烟类别下慢性病对残疾负担（disability burden）的贡献。 ## 方法 本研究纳入了1997、2001、2004及2008年比利时健康访谈调查（Health Interview Surveys）中10224名年龄40至60岁的受试者数据。吸烟状态被划分为从不吸烟者、戒烟≥2年的既往吸烟者（former smoker）、原文存在格式缺失的分类项、每日少量吸烟者（daily light smoker）与每日大量吸烟者（daily heavy smoker）。 ## 结果 各吸烟类别的残疾患病率呈上升趋势：男性群体中，从不吸烟者为4.8%、戒烟≥2年的既往吸烟者为5.8%、每日少量吸烟者为7.8%、每日大量吸烟者为10.7%；女性群体中，从不吸烟者为7.6%、戒烟≥2年的既往吸烟者为8.0%、每日少量吸烟者为10.2%、每日大量吸烟者为12.0%。 肌肉骨骼疾病（musculoskeletal conditions）对男女各吸烟类别的残疾负担均存在显著贡献。其他重要贡献因素如下：从不吸烟者为抑郁症（depression）与心血管疾病（cardiovascular diseases）；戒烟≥2年的既往吸烟者为抑郁症、慢性呼吸系统疾病（chronic respiratory diseases）与糖尿病（diabetes）；每日少量吸烟者为慢性呼吸系统疾病、癌症与心血管疾病；每日大量吸烟者中，男性的贡献因素为心血管疾病与慢性呼吸系统疾病，女性则为抑郁症与糖尿病。 ## 结论 除了众所周知的吸烟对死亡率的影响外，本研究结果还显示，不同吸烟类别的残疾患病率呈上升趋势，且残疾负担的贡献因素存在群体差异。这些信息可从公共卫生（public health）视角为比利时制定降低残疾风险的策略提供参考依据。