Study objective: To examine the association of
cigarette smoking and alcohol consumption with hospital presentation of
ARDS in a well-defined, multiethnic population.
Design: Retrospective cohort study.
Setting: Health maintenance organization in Northern
Participants: A total of 121,012 health
plan subscribers (54.2% women), aged 25 to 89 years.
Outcome measure: Hospital presentation of ARDS (validated
by medical chart review) from baseline in 1979 to 1985 through the end
of 1993 (median, 9.9 years).
Results: There were 56
cases of ARDS (33 in men, 23 in women). The case fatality rate was 39%
in both genders. ARDS was independently related to increasing age (rate
ratio of 10 years, 1.38; 95% confidence interval [CI], 1.12 to
1.71), to current smoking of < 20 cigarettes/d (rate ratio vs never
cigarette smokers, 2.85; 95% CI, 1.23 to 6.60), and to current
cigarette smoking of ≥ 20 cigarettes/d (rate ratio vs never smokers,
4.59; 95% CI, 2.13 to 9.88). No association was observed between
alcohol consumption and ARDS.
results of this study suggest a relationship (with evidence of
dose-response effect) between cigarette smoking and ARDS.
Assuming a causal relationship, approximately 50% of ARDS cases were
attributable to cigarette smoking.