ArticleTobacco induced diseases2026
The associations between tobacco exposure and diarrhea within the National Health and Nutrition Examination Survey (NHANES).
Article in Tobacco induced diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionAs a common clinical symptom, diarrhea imposes considerable burdens on patients' lives and healthcare. Smoking and secondhand smoke (SHS) exposure, as modifiable risk factors, currently exhibit an uncertain relationship with diarrhea, lacking relative studies to clarify the relationship. The study aims to clarify the relationship between different tobacco exposure situations and diarrhea.
methodsThis is a secondary analysis of 2005-2010 NHANES data, following a cross-sectional analytical design. Tobacco exposure in the population was divided into four groups (smokers, ex-smokers, never smokers exposed to SHS, and never smokers not exposed to SHS) based on smoking status and household SHS exposure. Diarrhea was ascertained using the Bristol Stool Form Scale (BSFS). Logistic regression analyses evaluated associations between tobacco exposure and diarrhea, with stratification analysis conducted to validate the robustness of findings. Additionally, we examined the potential mediating role of serum nicotine in this relationship.
resultsCompared to never smokers not exposed to SHS, smokers demonstrated a significantly elevated likelihood of diarrhea (AOR=1.56; 95% CI: 1.25-1.93). However, this association was not observed among ex-smokers or never smokers exposed to SHS. Among smokers, those who reported smoking immediately after waking showed an increased likelihood of reporting diarrhea (AOR=1.69; 95% CI: 1.17-2.45). Each additional year of smoking duration was associated with a 2% increase in the likelihood of diarrhea (AOR=1.02; 95% CI: 1.00-1.03) while daily cigarette consumption showed no significant association. Serum cotinine was not a mediator in the relationship between tobacco exposure and diarrhea.
conclusionsActive tobacco exposure is associated with an elevated likelihood of diarrhea, whereas no association was found for either passive smoking or former smoking. Both smoking duration and smoking immediately upon waking exhibit positive associations with heightened diarrhea likelihood, suggesting potential intestinal health benefits from smoking cessation at an earlier stage. Serum cotinine did not mediate this relationship.
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