Cigarette use is a known risk factor for the development of coronary artery disease (CAD) as it adversely affects HDL cholesterol levels and promotes thrombogenesis. Smoking may also be associated with behavioral characteristics that potentiate the risk of CAD. A lack of cholesterol knowledge would indicate an aversion to a prevention-oriented lifestyle. Thus, our goal was to determine the association between tobacco use and knowledge of self-reported cholesterol among male physicians. Using the 1982 and follow-up questionnaires from the physician health study, we report the changes in the frequencies of awareness of self-reported total cholesterol and cardiovascular risk factors among the 22,067 participants. We classified physicians as being aware of their cholesterol if they reported a cholesterol level and unaware if the question was left unanswered. In 1997, 207 physicians were excluded, as the recorded cholesterol was not interpretable, leaving 21,860 for our follow up analyses. Using unadjusted logistic models, we determined the odds ratios (OR) and 95% confidence intervals (CI) of not reporting a cholesterol level in either 1982 or 1997 for each specified risk factor. We then evaluated whether the lack of cholesterol awareness at both time points was associated with the use of tobacco throughout the study. After 14-years of follow up, cholesterol awareness increased from 35.9 to 58.6 percent. During this period, the frequency of hypertension and hyperlipidemia treatment increased (13.5 to 40.5% and 0.57% to 19.6% respectively), as did the diagnosis of diabetes (2.40 to 7.79%). Behavioral characteristics such as a sedentary lifestyle and obesity also increased (27.8 to 42% and 43.5 to 53.5%, respectively), however the proportion of current smokers deceased from 11.1 to 4.05%. The percentages of individuals being unaware of their cholesterol decreased in all risk factor groups. However, individuals were likely to be unaware of their cholesterol at both time points if they were current smokers (1982 OR 1.44, CI 1.4-1.7; 1997 OR 1.71, CI 1.48-1.97), past smokers (1982 OR 1.12, CI 1.05-1.18; 1997 OR 1.13, CI 1.06-1.20), overweight (BMI 25 kg/m2) or sedentary. In addition, physicians who never quit smoking were likely to be unaware of their cholesterol throughout the study (OR 1.42, CI 1.21-1.67). Cholesterol awareness in general and among those with CAD risk factors improved after 14-years of follow-up. However, the likelihood of being unaware was greater among smokers at both time points. Therefore, smokers do not appear to take advantage of other preventive strategies that would minimize their risk of developing CAD.
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机译：吸烟是导致冠状动脉疾病（CAD）的已知危险因素，因为它会对HDL胆固醇水平产生不利影响并促进血栓形成。吸烟也可能与增强CAD风险的行为特征有关。缺乏胆固醇知识将表明对预防型生活方式的厌恶。因此，我们的目标是确定男性医生中烟草使用与自我报告的胆固醇知识之间的关联。使用1982年和医生健康研究的后续调查表，我们报告了22,067名参与者对自我报告的总胆固醇和心血管危险因素的认识频率的变化。如果医师报告胆固醇水平，我们将其分类为意识到胆固醇，并且不知道问题是否仍未得到解答。 1997年，由于无法解释所记录的胆固醇，排除了207位医生，剩下21,860位我们进行随访分析。使用未调整的逻辑模型，我们确定了每个特定风险因素在1982年或1997年未报告胆固醇水平的比值比（OR）和95％置信区间（CI）。然后，我们评估了在整个研究过程中两个时间点对胆固醇缺乏认识是否与吸烟有关。经过14年的随访，胆固醇的知晓率从35.9％上升至58.6％。在此期间，高血压和高脂血症的治疗频率增加（分别为13.5％至40.5％和0.57％至19.6％），糖尿病的诊断也有所增加（2.40％至7.79％）。久坐不动的生活方式和肥胖等行为特征也有所增加（分别为27.8％至42％和43.5％至53.5％），但是目前吸烟者的比例从11.1％下降至4.05％。在所有危险因素组中，不知道其胆固醇的个体百分比均下降。但是，如果当前吸烟者（1982 OR 1.44，CI 1.4-1.7; 1997 OR 1.71，CI 1.48-1.97），既往吸烟者（1982 OR 1.12，CI 1.05-），则在两个时间点个人都可能没有意识到自己的胆固醇。 1.18; 1997或1.13，CI 1.06-1.20），超重（BMI 25千克/平方米）或久坐。此外，在整个研究过程中，从未戒烟的医生很可能没有意识到自己的胆固醇（OR 1.42，CI 1.21-1.67）。随访14年后，总体胆固醇意识和具有CAD危险因素的人们的胆固醇意识得到改善。但是，在两个时间点，吸烟者不了解的可能性更大。因此，吸烟者似乎没有利用其他预防策略来将其患上CAD的风险降至最低。
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