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

tetano

Editor, Senior Moderator
Eur J Public Health. 2017 Sep 8. doi: 10.1093/eurpub/ckx130. [Epub ahead of print]
[h=1]Smoking may increase the risk of influenza hospitalization and reduce influenza vaccine effectiveness in the elderly.[/h] Godoy P[SUP]1,[/SUP][SUP]2,[/SUP][SUP]3[/SUP], Castilla J[SUP]2,[/SUP][SUP]4[/SUP], Soldevila N[SUP]2,[/SUP][SUP]5[/SUP], Mayoral JM[SUP]6[/SUP], Toledo D[SUP]2,[/SUP][SUP]5[/SUP], Mart?n V[SUP]2,[/SUP][SUP]7[/SUP], Astray J[SUP]2,[/SUP][SUP]8[/SUP], Egurrola M[SUP]9[/SUP], Morales-Suarez-Varela M[SUP]2,[/SUP][SUP]10[/SUP], Dom?nguez A[SUP]2,[/SUP][SUP]5[/SUP]; CIBERESP Cases and Controls in Pandemic Influenza Working Group, Spain.
[h=3]Author information[/h]

[h=3]Abstract[/h] [h=4]Background:[/h] 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.
[h=4]Methods:[/h] 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.
[h=4]Results:[/h] 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).
[h=4]Conclusions:[/h] 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.


PMID: 29020390 DOI: 10.1093/eurpub/ckx130
 
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