Lifetime cannabis exposure and small airway function in a population-based cohort study

Hua Shin Tan; Helena M. McAnally; Jack Dummer; Robert J. Hancox

doi:10.1183/23120541.00688-2021

Tables

Supplementary Materials

TABLE 1

Descriptive values

	Whole sample	Women	Men
Cannabis use (joint-years)	0.08 (0–28)	0.03 (0–26.45)	0.17 (0–28)
Cannabis use (non-tobacco users only)	0.01 (0–28)	0 (0–19.32)	0.03 (0–28)
Cannabis use (tobacco and cannabis users only)	0.62 (0.003–27.97)	0.23 (0.003–26.45)	2.12 (0.003–27.97)
Tobacco use (pack-years)	0.11 (0–51.03)	0.25 (0–41.41)	0 (0–51.03)
BMI (kg·m⁻²)	27.6 (16.2–62.2)	27.1 (16.2–62.2)	27.8 (19.0–47.5)
Childhood SES	3.3 (1–6)	3.3 (1–6)	3.3 (1–6)
Adult SES	4 (1–6)	4 (1–6)	4 (1–6)

Data are presented as median (range). Socioeconomic status (SES) is on a 1–6 scale with 1 representing the highest SES. Childhood SES is based on parental occupations between birth and age 15 years. Adult SES is based on occupation at age 45 years.

TABLE 2

Pre-bronchodilator impulse oscillometry (IOS) values at age 45 years

	Women		Men
	Participants (n)	Mean (95% CI)	Participants (n)	Mean (95% CI)
R₅ (cmH₂O·L·s⁻¹)	441	5.17 (5.00–5.35)	454	4.49 (4.34–4.64)
R₂₀ (cmH₂O·L·s⁻¹)	441	4.15 (4.01–4.28)	454	3.65 (3.54–3.77)
R₅–R₂₀ (cmH₂O·L·s⁻¹)	441	1.03 (0.94–1.13)	454	0.84 (0.76–0.84)
X₅ (cmH₂O·L·s⁻¹)	440	−1.60 (−1.69– −1.50)	454	−1.19 (−1.26– −1.12)
AX (cmH₂O·L·s⁻¹)	437	6.99 (6.32–7.67)	449	4.86 (4.35–5.37)
f_res (Hz)	440	14.29 (13.81–14.77)	452	13.06 (12.61–13.51)

Means are geometric means of raw IOS values. The n values differ slightly because of missing data. R₅: resistance at 5 Hz; R₂₀: resistance at 20 Hz; R₅−R₂₀: difference between R₅ and R₂₀; X₅: reactance at 5 Hz; AX: area under the reactance curve between 5 Hz and resonant frequency (f_res).

TABLE 3

Adjusted associations of cannabis and tobacco with pre-bronchodilator impulse oscillometry (IOS) measures for the whole sample

	R₅	R₂₀	R₅−R₂₀	X₅	AX	f_res
Participants (n)	877	877	877	876	868	870
Joint-years
β (95% CI)	0.104 (0.033–0.175)	0.073 (−0.001–0.148)	0.086 (0.013–0.158)	0.110 (0.039–0.174)	0.130 (0.060–0.200)	0.133 (0.062–0.204)
p-value	0.004	0.054	0.020	0.002	<0.001	<0.001
Pack-years
β (95% CI)	0.042 (−0.029–0.113)	0.003 (−0.072–0.077)	0.076 (0.004–0.149)	0.041 (−0.027–0.108)	0.052 (−0.018–0.123)	0.047 (−0.025–0.119)
p-value	0.248	0.946	0.039	0.237	0.147	0.197
Interaction term^# (p-value)	0.031	0.131	0.034	0.062	0.034	0.054

All IOS measures are log-transformed and analyses are adjusted for use of both substances and also adjusted for sex, body mass index and height. Bolded values are statistically significant. β-values are standardised regression coefficients, which represent the standard deviation difference in IOS measure associated with each standard deviation change in joint- or pack-years. R₅: resistance at 5 Hz; R₂₀: resistance at 20 Hz; R₅−R₂₀: difference between R₅ and R₂₀; X₅: reactance at 5 Hz; AX: area under the reactance curve between 5 Hz and resonant frequency (f_res). ^#: interaction term p-values are for joint-years by sex in the adjusted model for each IOS measure tested for after the adjusted model was run.

TABLE 4

Adjusted associations of cannabis and tobacco with pre-bronchodilator impulse oscillometry (IOS) measures stratified by sex

	R₅	R₂₀	R₅−R₂₀	X₅	AX	f_res
Women
Participants (n)	434	434	434	433	430	432
Joint-years
β (95% CI)	0.187 (0.058–0.315)	0.150 (0.014–0.286)	0.137 (−0.007–0.281)	0.234 (0.109–0.358)	0.240 (0.116–0.364)	0.222 (0.095–0.350)
p-value	0.004	0.030	0.061	<0.001	<0.001	0.001
Pack-years
β (95% CI)	0.058 (−0.058–0.175)	−0.005 (−0.128–0.119)	0.139 (0.009–0.270)	−0.038 (−0.151–0.075)	0.015 (−0.098–0.128)	0.030 (−0.086–0.146)
p-value	0.327	0.940	0.037	0.510	0.796	0.612
Men
Participants (n)	443	443	443	443	438	438
Joint-years
β (95% CI)	0.070 (−0.015–0.156)	0.042 (−0.047–0.132)	0.066 (−0.011–0.143)	0.053 (−0.026–0.113)	0.083 (−0.003–0.168)	0.094 (0.009–0.179)
p-value	0.107	0.351	0.095	0.186	0.058	0.030
Pack-years
β (95% CI)	0.024 (−0.066–0.114)	<0.001 (−0.095–0.094)	0.032 (−0.049–0114)	0.079 (−0.005–0.163)	0.067 (−0.024–0.158)	0.051 (−0.040–0.142)
p-value	0.599	0.996	0.437	0.064	0.150	0.272

All IOS measures are transformed and analyses are adjusted for use of both substances and also adjusted for body mass index and height; significant associations are shown in bold. β-values are standardised regression coefficients, which represent the standard deviation difference in IOS measure associated with each standard deviation change in joint- or pack-years. R₅: resistance at 5 Hz; R₂₀: resistance at 20 Hz; R₅−R₂₀: difference between R₅ and R₂₀; X₅: reactance at 5 Hz; AX: area under the reactance curve between 5 Hz and resonant frequency (f_res).

TABLE 5

Longitudinal analyses of cannabis and tobacco use between ages 38 and 45 years with pre-bronchodilator impulse oscillometry (IOS) measures for the whole sample

	R₅	R₂₀	R₅−R₂₀	X₅	AX	f_res
Participants (n)	864	864	864	862	856	857
Joint-years 38–45 years
β (95% CI)	0.078 (0.023–0.132)	0.060 (−0.002–0.121)	0.043 (−0.014–0.100)	0.059 (0.003–0.114)	0.076 (0.023–0.129)	0.091 (0.037–0.145)
p-value	0.005	0.056	0.140	0.038	0.005	0.001
Pack-years 38–45 years
β (95% CI)	0.017 (−0.038–0.072)	−0.004 (−0.066–0.058)	0.044 (−0.014–0.101)	0.048 (−0.009–0.104)	0.037 (−0.016–0.091)	0.015 (−0.040–0.069)
p-value	0.553	0.903	0.134	0.099	0.173	0.601

All IOS measures are log-transformed. Analyses are adjusted for use of both substances and also adjusted for sex, body mass index, height and the relevant IOS measure at age 38 years (e.g. resistance at 5 Hz (R₅) at 38 years is the adjustment for age 45 years R₅); bolded values are statistically significant. β-values are standardised regression coefficients, which represent the standard deviation difference in IOS measure associated with each standard deviation change in joint- or pack-years. R₂₀: resistance at 20 Hz; R₅−R₂₀: difference between R₅ and R₂₀; X₅: reactance at 5 Hz; AX: area under the reactance curve between 5 Hz and resonant frequency (f_res).

TABLE 6

Longitudinal analyses of cannabis and tobacco use between ages 38 and 45 years with pre-bronchodilator impulse oscillometry (IOS) measures stratified by sex

	R₅	R₂₀	R₅−R₂₀	X₅	AX	f_res
Women
Participants (n)	426	426	426	425	422	423
Joint-years 38–45 years
β (95% CI)	0.125 (0.035–0.214)	0.075 (−0.025–0.176)	0.085 (−0.019–0.189)	0.125 (0.035–0.218)	0.140 (0.054–0.226)	0.129 (0.042–0.217)
p-value	0.006	0.142	0.109	0.008	0.001	0.004
Pack-years 38–45 years
β (95% CI)	0.002 (−0.107–0.111)	−0.007 (−0.129–0.115)	0.077 (−0.049–0.203)	−0.064 (−0.176–0.047)	−0.017 (−0.121–0.087)	0.013 (−0.093–0.120)
p-value	0.972	0.906	0.232	0.258	0.749	0.804
Men
Participants (n)	438	438	438	437	434	434
Joint-years 38–45 years
β (95% CI)	0.049 (−0.019–0.117)	0.049 (−0.029–0.127)	0.015 (−0.047–0.077)	0.023 (−0.045–0.091)	0.039 (−0.028–0.107)	0.066 (−0.003–0.135)
p-value	0.158	0.214	0.644	0.510	0.255	0.062
Pack-years 38–45 years
β (95% CI)	0.025 (−0.038–0.088)	<0.001 (−0.073–0.073)	0.034 (−0.023–0.091)	0.093 (0.029–0.157)	0.060 (−0.003–0.122)	0.017 (−0.047–0.081)
p-value	0.432	0.999	0.242	0.005	0.063	0.601

All IOS measures are log-transformed and analyses are adjusted for use of both substances and also adjusted for body mass index, height and the relevant IOS measure at age 38 years (e.g. resistance at 5 Hz (R₅) at 38 years is the adjustment for age 45 years R₅); statistically significant associations are bolded. β-values are standardised regression coefficients, which represent the standard deviation difference in IOS measure associated with each standard deviation change in joint- or pack-years. R₂₀: resistance at 20 Hz; R₅−R₂₀: difference between R₅ and R₂₀; X₅: reactance at 5 Hz; AX: area under the reactance curve between 5 Hz and resonant frequency (f_res).

Supplementary Materials

Tables

Supplementary Material
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Supplementary material 00688-2021.SUPPLEMENT