Association of tobacco product use with chronic obstructive pulmonary disease (COPD) prevalence and incidence in Waves 1 through 5 (2013–2019) of the Population Assessment of Tobacco and Health (PATH) Study

Table 3 Association between Wave 1 past 30-day tobacco use and COPD^a prevalence at Wave 1 of the Population Assessment of Tobacco and Health Study

Twelve mutually exclusive categories of Wave 1 tobacco use^b	Weighted Percent with COPD (SE)^c	Covariate adjustment
	Weighted Percent with COPD (SE)^c	Unadjusted (N = 12,838)		Cigarette pack-years (N = 12,343)		Fully adjusted^d (N = 11,822)
Exclusive cigarette as the reference group		COPD prevalence (RR)	95% CI	COPD prevalence (RR)	95% CI	COPD prevalence (RR)	95% CI
Exclusive P30D cigarette	16.7 (0.7)	Ref	Ref	Ref	Ref	Ref	Ref
Never use (Never or former experimental tobacco)	3.2 (0.3)	0.19***	[0.15,0.24]	0.38***	[0.30,0.48]	0.33***	[0.26,0.42]
Former tobacco use	10.1 (0.7)	0.61***	[0.52,0.71]	0.63***	[0.54,0.74]	0.57***	[0.47,0.70]
Exclusive P30D e-cigarette	12.1 (2.9)	0.73	[0.44,1.20]	0.64	[0.39,1.05]	0.74	[0.46,1.19]
Exclusive P30D cigar	4.6 (1.1)	0.28***	[0.18,0.43]	0.37***	[0.23,0.60]	0.46**	[0.28,0.76]
Exclusive P30D smokeless/snus	5.8 (1.8)	0.35**	[0.18,0.67]	0.49*	[0.26,0.94]	0.55	[0.28,1.06]
Exclusive P30D cigarette and e-cigarette	18.6 (1.7)	1.12	[0.93,1.35]	1.08	[0.90,1.30]	1.03	[0.86,1.24]
P30D polycombusted tobacco use	17.2 (1.7)	1.03	[0.84,1.28]	1.05	[0.86,1.28]	1.12	[0.91,1.38]
P30D polycombusted and noncombusted use	15.6 (1.6)	0.93	[0.76,1.15]	0.92	[0.74,1.15]	0.92	[0.71,1.18]

Never tobacco use as the reference group		COPD prevalence (RR)	95% CI	COPD prevalence (RR)	95% CI	COPD prevalence (RR)	95% CI
Never use (Never or former experimental tobacco)	3.2 (0.3)	Ref	Ref	Ref	Ref	Ref	Ref
Former tobacco use	10.1 (0.7)	3.21***	[2.49,4.14]	1.66***	[1.27,2.17]	1.72***	[1.33,2.23]
Exclusive P30D cigarette	16.7 (0.7)	5.28***	[4.25,6.57]	2.63***	[2.07,3.34]	3.00***	[2.37,3.80]
Exclusive P30D e-cigarette	12.1 (2.9)	3.84***	[2.35,6.28]	1.68*	[1.02,2.77]	2.22***	[1.44,3.42]
Exclusive P30D cigar	4.6 (1.1)	1.46	[0.90,2.37]	0.97	[0.58,1.62]	1.38	[0.82,2.33]
Exclusive P30D smokeless/snus	5.8 (1.8)	1.85	[0.95,3.62]	1.29	[0.67,2.48]	1.63	[0.87,3.07]
Exclusive P30D cigarette and e-cigarette	18.6 (1.7)	5.91***	[4.55,7.67]	2.84***	[2.14,3.76]	3.10***	[2.39,4.02]
P30D polycombusted tobacco use	17.2 (1.7)	5.47***	[4.05,7.37]	2.75***	[2.00,3.77]	3.37***	[2.44,4.65]
P30D polycombusted and noncombusted use	15.6 (1.6)	4.94***	[3.67,6.65]	2.42***	[1.74,3.36]	2.74***	[1.98,3.80]

^a COPD: Chronic Obstructive Pulmonary Disease, defined as self-report of emphysema, chronic bronchitis, or COPD
^bData are not presented for exclusive hookah, exclusive pipe, and dual e-cigarette + smokeless/snus users due to small sample size. Never tobacco user category includes former experimental (e.g., lifetime use of < 100 cigarettes or never used other products fairly regularly) users; former established user category includes all established users (e.g., lifetime use of more than 100 cigarettes or ever used other products fairly regularly) who did not use any tobacco products in the past 30 days
^cOverall Wave 1 prevalence was 7.7% (SE = 0.3)
^dFully adjusted = Risk ratios (RR) are adjusted for cigarette pack-years (never cigarette users were assigned 0 pack-years), past-week secondhand smoke exposure, past 30-day marijuana use, COPD comorbidity index, ever asthma diagnosis, age, sex, race/ethnicity, education, and urbanicity. See Additional file 1: Tablesecond
S1a and S1b for all covariate estimates
*p < 0.05, ** p < 0.01, *** p < 0.001

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