Heterogeneous impact of tea consumption on COPD risk in smokers: insights from the PIFCOPD Study

Yijing Li¹Jiping Liao¹Ruiying Wang²Xiuhua Fu³Xiaomin Dang⁴Hua Qiao⁵Lixia Dong⁶Jianhong Xiao⁷Shujuan Jiang⁸Jinzhi Yin⁹Weihua Jia¹⁰Xixin Yan¹¹Yunxia Wang¹Cheng Zhang¹Kunyao Yu¹Guifang Zhang¹²Jing Li²Rui Chen³Bo Zhou⁴Mengyu Yin⁶Shaochen Dong⁵Jian Sun⁸Peng Gao⁹Bifang Miao⁷Beibei Song¹¹Liping Xie¹⁰Lan He³Qian Ning⁴Lina Zhang¹³Wei Li⁹Qi Zhang¹Kunyan Sun¹Chunbo Zhang¹Xiaoyu Ma¹Guangfa Wang^1*

• ¹First Hospital, Peking University, Beijing, China
• ²Shanxi Bethune Hospital, Taiyuan, China
• ³The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China
• ⁴The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
• ⁵First Hospital of Qinhuangdao, Qinhuangdao, China
• ⁶Tianjin Medical University General Hospital, Tianjin, China
• ⁷Ningde Mindong hospital, Ningde, China
• ⁸Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
• ⁹The Second Hospital of Jilin University, Changchun, China
• ¹⁰Taiyuan Iron and Steel Group Co Ltd General Hospital, Taiyuan, China
• ¹¹The Second Hospital of Hebei Medical University, Shijiazhuang, China
• ¹²Jinyuan Community Health Service Centre, Taiyuan, China
• ¹³Jining No 1 People's Hospital, Jining, China

Background: Chronic obstructive pulmonary disease (COPD) is a highly prevalent disease worldwide, with smoking identified as the main risk factor. Emerging evidence suggests that tea consumption may confer protective effects on lung health. However, it remains unclear whether tea consumption can mitigate the adverse effects of smoking on COPD risk. This study aimed to investigate the association between tea consumption and COPD risk, and to examine whether this association differs by smoking status. Methods: The Predictive Value of Inflammatory Biomarkers and Forced Expiratory Volume in 1 second (PIFCOPD) study is a multicenter prospective cohort (2018-2021) involving 7,252 participants (6,855 with normal lung function; 397 with COPD). Data on demographic characteristics, smoking status, and tea consumption were collected. Logistic regression analysis was used to assess the association between tea consumption and COPD risk. Interaction and stratified analyses based on smoking status were performed. Results: The proportion of tea consumption was 20.9% in the normal lung function group and 24.4% in the COPD group, with no significant difference. Tea consumption was not associated with COPD risk in the general population. However, interaction and stratified analysis based on smoking status showed that fully fermented tea consumption was associated with a protective effect against COPD in smokers (OR 0.21), especially when consumed ≥ 7 times per week and for ≥ 10 years. In contrast, jasmine tea emerged as a potential risk factor (OR 1.99), especially when consumed for ≥ 10 years. Conclusion: In the general population, the effect of tea consumption on the prevalence risk of COPD is significant only in smokers, and this effect is modulated by the type, frequency and duration of tea consumption.