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Effects of tobacco smoking on recurrent hospitalisation with pneumonia: a population-based cohort study
  1. Vadsala Baskaran1,2,3,
  2. Wei Shen Lim2,
  3. Tricia M McKeever1,3
  1. 1 Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK
  2. 2 Respiratory Medicine, Nottingham University Hospitals NHS Trust, Nottingham, UK
  3. 3 National Institute for Health Research (NIHR), Nottingham Biomedical Research Centre, Nottingham, UK
  1. Correspondence to Dr Vadsala Baskaran, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, Nottingham, UK; reksha_01{at}


The incidence of and risk factors for recurrent hospitalisation for pneumonia were investigated using data from Hospital Episode Statistics, linked to a UK primary care database. Within 90 days and 1 year of follow-up, 1733 (3.1%) and 5064 (9.0%), developed recurrent pneumonia respectively. Smoking status at the time of hospitalisation with index pneumonia was associated with the risk of readmission with recurrent pneumonia within a year of discharge: current versus never smokers: adjusted subhazard ratio (sHR) 1.42, 95% CI 1.32 to 1.53, p<0.001, and ex smokers versus never smokers: adjusted sHR 1.24, 95% CI 1.15 to 1.34, p<0.001. Other independent risk factors associated with recurrent pneumonia were age, gender, deprivation and underlying comorbidities.

  • pneumonia
  • tobacco and the lung
  • clinical epidemiology

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  • Contributors VB, WSL and TMMcK had substantial contributions to the study conception and design. VB had substantial contributions to the data acquisition and analysis and wrote the original draft. All authors fulfilled the criteria of authorship; contributed to the interpretation for the study; revised the manuscript critically for important intellectual content, provided the final approval of the version to be published and agreed to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

  • Funding This research was funded by the NIHR Nottingham Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health and Social Care (grant number: BRC-1215–20003).

  • Competing interests WSL reports grants from National Institute for Health Research and Pfizer outside the submitted work.

  • Provenance and peer review Not commissioned; externally peer reviewed.