Cigarette smoking, alcohol consumption, and risk of ARDS: A 15-year cohort study in a managed care setting

Carlos Iribarren, David R. Jacobs, Stephen Sidney, Myron D. Gross, Mark D. Eisner

Research output: Contribution to journalArticlepeer-review

110 Scopus citations


Study objective: To examine the association of cigarette smoking and alcohol consumption with hospital presentation of ARDS in a well-defined, multiethnic population. Design: Retrospective cohort study. Setting: Health maintenance organization in Northern California. Participants: A total of 121,012 health plan subscribers (54.2% women), aged 25 to 89 years. Outcome measure: Hospital presentation of ARDS (validated by medical chart review) from baseline in 1979 to 1985 through the end of 1993 (median, 9.9 years). Results: There were 56 cases of ARDS (33 in men, 23 in women). The case fatality rate was 39% in both genders. ARDS was independently related to increasing age (rate ratio of 10 years, 1.38; 95% confidence interval [CI], 1.12 to 1.71), to current smoking of < 20 cigarettes/d (rate ratio vs never cigarette smokers, 2.85; 95% CI, 1.23 to 6.60), and to current cigarette smoking of ≥ 20 cigarettes/d (rate ratio vs never smokers, 4.59; 95% CI, 2,13 to 9.88). No association was observed between alcohol consumption and ARDS. Conclusions: The results of this study suggest a relationship (with evidence of dose-response effect) between cigarette smoking and ARDS. Assuming a causal relationship, approximately 50% of ARDS cases were attributable to cigarette smoking.

Original languageEnglish (US)
Pages (from-to)163-168
Number of pages6
Issue number1
StatePublished - 2000

Bibliographical note

Funding Information:
This study was supported by contract RO1-AG-12264–01A1 from the National Institute on Aging, National Institutes of Health, Bethesda, MD.


  • ARDS
  • Alcohol
  • Epidemiology
  • Risk factors
  • Smoking


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