Prevalence and Effects of Cigarette Smoking, Cannabis Consumption, and Co-use in Adults From 15 Countries With Congenital Heart Disease
Journal
Canadian Journal of Cardiology
Journal Volume
35
Journal Issue
12
Pages
1842-1850
Date Issued
2019
Author(s)
Moons P.
Luyckx K.
Kovacs A.H.
Holbein C.E.
Thomet C.
Budts W.
Enomoto J.
Sluman M.A.
Jackson J.L.
Khairy P.
Cook S.C.
Chidambarathanu S.
Alday L.
Eriksen K.
Dellborg M.
Berghammer M.
Johansson B.
Mackie A.S.
Menahem S.
Caruana M.
Veldtman G.
Soufi A.
Fernandes S.M.
White K.
Callus E.
Kutty S.
Apers S.
APPROACH-IS Consortium and the International Society for Adult Congenital Heart Disease (ISACHD)
Abstract
Background: The prevalence and effects of cigarette smoking and cannabis use in persons with congenital heart disease (CHD) are poorly understood. We (1) described the prevalence of cigarette smoking, cannabis consumption, and co-use in adults with CHD; (2) investigated intercountry differences; (3) tested the relative effects on physical functioning, mental health, and quality of life (QOL); and (4) quantified the differential effect of cigarette smoking, cannabis use, or co-use on those outcomes. Methods: APPROACH-IS was a cross-sectional study, including 4028 adults with CHD from 15 countries. Patients completed questionnaires to measure physical functioning, mental health, and QOL. Smoking status and cannabis use were assessed by means of the Health Behaviour Scale—Congenital Heart Disease. Linear models with doubly robust estimations were computed after groups were balanced with the use of propensity weighting. Results: Overall, 14% of men and 11% of women smoked cigarettes only; 8% of men and 4% of women consumed cannabis only; and 4% of men and 1% of women used both substances. Large intercountry variations were observed, with Switzerland having the highest prevalence for smoking cigarettes (24% of men, 19% of women) and Canada the highest for cannabis use (19% of men, 4% of women). Cigarette smoking had a small negative effect on patient-reported outcomes, and the effect of cannabis was negligible. The effect of co-use was more prominent, with a moderate negative effect on mental health. Conclusions: We found significant intercountry variability in cigarette and cannabis use in adults with CHD. Co-use has the most detrimental effects on patient-reported outcomes. ? 2019 Canadian Cardiovascular Society
SDGs
Other Subjects
adult; anxiety; Article; Canada; cannabis use; cigarette smoking; congenital heart disease; cross-sectional study; depression; female; human; life satisfaction; major clinical study; male; patient-reported outcome; questionnaire; Switzerland; adolescent; adverse event; age distribution; analysis of variance; cannabis smoking; cigarette smoking; clinical trial; congenital heart malformation; global health; health status; international cooperation; mental health; middle aged; multicenter study; nonparametric test; prevalence; quality of life; questionnaire; risk assessment; sex ratio; statistical model; young adult; Adolescent; Adult; Age Distribution; Analysis of Variance; Cigarette Smoking; Cross-Sectional Studies; Female; Global Health; Health Status; Heart Defects, Congenital; Humans; Internationality; Linear Models; Male; Marijuana Smoking; Mental Health; Middle Aged; Prevalence; Quality of Life; Risk Assessment; Sex Distribution; Statistics, Nonparametric; Surveys and Questionnaires; Young Adult
Type
journal article