ERS Respiratory Channel

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Abstract

Background

In China, chronic obstructive pulmonary disease (COPD) is one of the most common chronic diseases. The prevalence of and risk factors for non-smoker COPD in China remains to be known.

Objectives

To estimate the proportion of non-smokers in COPD patients and to evaluate the risk factors for COPD in non-smokers in China.

Data sources

Six databases from inception to 1st May 2022 were searched.

Results

Overall, 95 studies with a total of 482,158 participants were included. The percentage of never-smokers among people with COPD was 42% (95% CI: 38% to 45%, P < 0.001). The proportion of never-smokers in males with COPD was 22% (95% CI: 19% to 26%, P < 0.001), which was different from that in females (81%, 95% CI: 75% to 87%, P < 0.001).

The results showed an association between biomass fuel and COPD in never-smokers (OR: 1.25, 95%?CI: 1.06 to 1.44). Data from four studies showed a close association between underweight and COPD in never-smokers (OR: 1.89, 95%?CI 1.78 to 2.00). An association between history of tuberculosis and COPD was also observed in never-smokers (OR: 1.71, 95%?CI 1.53 to 1.88). No associations were identified for passive smoking and COPD in never-smokers (OR: 0.90, 95%?CI 0.87 to 0.94). Interestingly, data from three studies showed being male gender was associated with a risk for COPD in nonsmokers (OR: 1.36, 95%?CI 1.22 to 1.51). Never-smokers living in rural areas or those with low educational status were more susceptible to COPD.

Conclusions

This review confirmed the highly different proportions of never-smokers in male and female COPD patients. Biomass fuel might have important roles in the risk for COPD among never-smokers.

Abstract

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