Substance Use and Misuse among Adults with Chronic Obstructive Pulmonary Disease in the United States, 2015-2019: Prevalence, Association, and Moderation.

Abdullah M M Alanazi,Linda Gibson-Young,Moudi M Alasmari,Eyas A Alhuthail,Wasantha P Jayawardene,Ahmad A Alanazi,Taha T Ismaeil,Tareq F Alotaibi,Maher M Alquaimi,Mohammed M Alqahtani,Saleh S Algarni,Ali M Alasmari

doi:10.3390/ijerph19010408

Abstract

Background: Despite the advancements in chronic obstructive pulmonary disease (COPD) treatment, complications related to COPD exacerbation remain challenging. One associated factor is substance use/misuse among adults with COPD. Fewer studies, however, examined the prevalence and association between COPD and substance use and misuse. In addition, limited knowledge existed about the moderation effects of serious psychological distress and gender among adults with COPD and substance use/misuse. We aimed, therefore, to measure such prevalence, association, and moderation from nationally representative samples in the United States. Method: Data were drawn from the 2015–2019 National Survey on Drug Use and Health. Weighted logistic regressions were used to measure the associations of last-month tobacco (cigarettes, cigars, pipe, and smokeless tobacco products), other licit and illicit substance use (alcohol, marijuana, cocaine, crack, heroin, hallucinogens, and inhalants), and substance misuse (pain relievers, tranquilizers, stimulants, and sedatives) among adults with COPD. Serious psychological distress and gender were tested as moderators in the association between COPD and substance use/misuse. Results: The findings revealed that adults with COPD [Weighted N = 53,115,718) revealed greater odds of cigarettes [adjusted odds ratio (aOR) = 2.48 (95%CI = 1.80–3.42)) and smokeless tobacco (aOR = 3.65 (95%CI = 1.75–7.65)). However, they were less likely to use alcohol (aOR = 0.61 (95%CI = 0.45–0.84)). Adults with COPD who had serious psychological distress were more likely to use pipe tobacco and alcohol; however, they were less likely to use hallucinogens and inhalants. Finally, males compared to females with COPD were less likely to use smokeless tobacco. Conclusion: Adults with COPD in the United States were more likely to use tobacco products and less likely to use alcohol. In addition, serious psychological distress and gender were moderators in associations between COPD and substance use but not in substance misuse. Future studies should longitudinally assess the factors that may contribute to the initiation and progression of substance use and misuse among adults with COPD.

Highlights

Chronic obstructive pulmonary disease (COPD) encompasses heterogeneous progressive respiratory disorders that include chronic bronchitis and emphysema [1]
Lower status of educational attainments, lower income, and greater serious psychological distress were more prevalent in the chronic obstructive pulmonary disease (COPD) group than those without COPD
This study assessed the prevalence and association of substance use/misuse among adults with COPD and whether serious psychological distress and gender differences moderated this association from nationally representative samples in the United States

Summary

Introduction

Chronic obstructive pulmonary disease (COPD) encompasses heterogeneous progressive respiratory disorders that include chronic bronchitis and emphysema [1]. COPD are presented with airflow limitation and frequent pulmonary complications [2]. States has decreased from 2004 to 2018 (72.9 to 67.4 deaths per population of 100,000) [7]; significant diversity presents among adults with COPD based on mental health, gender, and risk-taking behaviors [7,8,9], one of which is smoking that has been documented as the most common risk factor for COPD etiology and exacerbation [9,10]. Smoking cessation is a standard of care for those who are diagnosed with COPD [11]; abstaining from tobacco use, showed promising health effects in limiting airway obstruction and ameliorating complications associated with COPD [12]. Despite the advancements in care, the associations between tobacco use and COPD remain high [13]

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