Differences in clinical features between current smokers and former smokers with OSA: a cross-sectional study

Smoking is both a cause of obstructive sleep apnea (OSA) and is an important reason for its rising prevalence. However, there is a lack of studies predicting smoking cessation specifically in patients with OSA. This study aimed to identify the factors linked to smoking cessation by examining and comparing the clinical characteristics of current smokers and former smokers with OSA. Eligible adults with a diagnosis of OSA and who were smokers (n = 504) were enrolled in the study. Data on demographics, PSG results, and clinical information were collected. Participants were categorized into current smokers and former smokers based on their smoking status. Logistic regression was used to analyze factors associated with smoking cessation and Cox proportional hazards regression to evaluate the interactions among these factors. Among all patients with OSA included in the study, 69.0% were current smokers, while 31.0% were former smokers. Compared to current smokers, former smokers were generally older, had a longer duration of OSA, exhibited a higher proportion of severe OSA, had more smoking pack-years and a longer smoking duration, a higher BMI, AHI, and ODI, and a lower MSaO₂. Logistic regression analysis revealed that smoking cessation was positively associated with factors such as age, disease duration, AHI, BMI, various clinical manifestations, and comorbidities, but negatively associated with MSaO₂. The Cox proportional hazards regression model indicated that among the factors related to smoking cessation, OSA severity interacted significantly with hyperuricemia, metabolic syndrome, obesity, and lacunar infarction (all P < 0.05). The factors related to smoking cessation identified in this study should be emphasized in interventions aimed at quitting smoking in OSA patients. Addressing these factors may help prevent the exacerbation of OSA and enhance patient outcomes.