Literature DB >> 29020390

Smoking may increase the risk of influenza hospitalization and reduce influenza vaccine effectiveness in the elderly.

Pere Godoy1,2,3, Jesús Castilla2,4, Núria Soldevila2,5, José María Mayoral6, Diana Toledo2,5, Vicente Martín2,7, Jenaro Astray2,8, Mikel Egurrola9, Maria Morales-Suarez-Varela2,10, Angela Domínguez2,5.   

Abstract

Background: Through its effects on the immune system, smoking may facilitate influenza virus infection, its severity and its most frequent complications. The objective was to investigate the smoking history as a risk factor for influenza hospitalization and influenza vaccine effectiveness in elderly smokers/ex-smokers and non-smokers.
Methods: We carried out a multicenter case-control study in the 2013-2014 and 2014-2015 influenza seasons. Cases aged ≥65 years and age-, sex-matched controls were selected from 20 Spanish hospitals. We collected epidemiological variables, comorbidities, vaccination history and the smoking history. The risk of hospitalization due to smoking (current smokers and ex-smokers) was determined using the adjusted odds ratio (aOR) with conditional logistic regression models. Vaccine effectiveness (VE) was calculated using the formula: VE = (1 - aOR) × 100.
Results: We studied 728 cases and 1826 controls. Cases had a higher frequency of smoking (47.4% vs 42.1%). Smoking was associated with an increased risk of influenza hospitalization (aOR = 1.32, 95% CI: 1.04-1.68). Influenza vaccine effectiveness in preventing hospitalization was 21% (95% CI: -2 to 39) in current/ex-smokers and 39% in non-smokers (95% CI: 22-52). Conclusions: A history of smoking may increase the risk of hospitalization in smokers and ex-smokers. Preventing smoking could reduce hospitalizations due to influenza. Smokers and ex-smokers should be informed of the risk of hospitalization due to influenza infection, and encouraged to stop smoking. Smokers should be considered an at-risk group to be aggressively targeted for routine influenza vaccination.
© The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

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Year:  2018        PMID: 29020390     DOI: 10.1093/eurpub/ckx130

Source DB:  PubMed          Journal:  Eur J Public Health        ISSN: 1101-1262            Impact factor:   3.367


  11 in total

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