BACKGROUND: The association between smoking and asthma or wheeze has been extensively studied in cross sectional studies, but evidence from large prospective cohort studies on the incidence of asthma during adolescence is scarce. METHODS: We report data from a cohort study in two German cities, Dresden and Munich. The study population (n = 2936) was first studied in 1995/6 at age 9-11 years as part of phase II of the International Study of Asthma and Allergies in Childhood (ISAAC II) and followed up in 2002/3. At baseline the parents completed a questionnaire and children underwent clinical examination and blood sampling. At follow up the young adults completed questionnaires on respiratory health, living, and exposure conditions. Incidence risk ratios (IRR) were calculated and adjusted for potential confounders using a modified Poisson regression approach. RESULTS: The adjusted IRR for incident wheeze for active smokers compared with non-smokers was 2.30 (95% confidence interval (CI) 1.88 to 2.82). The adjusted IRR was slightly higher for incident wheeze without a cold (2.76, 95% CI 1.99 to 3.84) and the incidence of diagnosed asthma (2.56, 95% CI 1.55 to 4.21). Analysis of duration and intensity of active smoking indicated dose dependent associations. Stratified analyses showed that the risk of incident wheeze without a cold in atopic smokers increased with decreasing plasma alpha(1)-antitrypsin levels at baseline (1.64, 95% CI 1.22 to 2.20 per interquartile range). CONCLUSIONS: Active smoking is an important risk factor for the incidence of asthma during adolescence. Relatively lower plasma levels of alpha(1)-antitrypsin, although well above currently accepted thresholds, may increase susceptibility to respiratory disease among atopic smokers.
BACKGROUND: The association between smoking and asthma or wheeze has been extensively studied in cross sectional studies, but evidence from large prospective cohort studies on the incidence of asthma during adolescence is scarce. METHODS: We report data from a cohort study in two German cities, Dresden and Munich. The study population (n = 2936) was first studied in 1995/6 at age 9-11 years as part of phase II of the International Study of Asthma and Allergies in Childhood (ISAAC II) and followed up in 2002/3. At baseline the parents completed a questionnaire and children underwent clinical examination and blood sampling. At follow up the young adults completed questionnaires on respiratory health, living, and exposure conditions. Incidence risk ratios (IRR) were calculated and adjusted for potential confounders using a modified Poisson regression approach. RESULTS: The adjusted IRR for incident wheeze for active smokers compared with non-smokers was 2.30 (95% confidence interval (CI) 1.88 to 2.82). The adjusted IRR was slightly higher for incident wheeze without a cold (2.76, 95% CI 1.99 to 3.84) and the incidence of diagnosed asthma (2.56, 95% CI 1.55 to 4.21). Analysis of duration and intensity of active smoking indicated dose dependent associations. Stratified analyses showed that the risk of incident wheeze without a cold in atopic smokers increased with decreasing plasma alpha(1)-antitrypsin levels at baseline (1.64, 95% CI 1.22 to 2.20 per interquartile range). CONCLUSIONS: Active smoking is an important risk factor for the incidence of asthma during adolescence. Relatively lower plasma levels of alpha(1)-antitrypsin, although well above currently accepted thresholds, may increase susceptibility to respiratory disease among atopic smokers.
Authors: S K Weiland; E von Mutius; T Hirsch; H Duhme; C Fritzsch; B Werner; A Hüsing; M Stender; H Renz; W Leupold; U Keil Journal: Eur Respir J Date: 1999-10 Impact factor: 16.671
Authors: Michael E J Wadsworth; Lynne E Vinall; Abigail L Jones; Rebecca J Hardy; David B Whitehouse; Suzanne L Butterworth; Warren S Hilder; Jennifer U Lovegrove; Dallas M Swallow Journal: Am J Respir Cell Mol Biol Date: 2004-07-22 Impact factor: 6.914
Authors: Frank D Gilliland; Talat Islam; Kiros Berhane; W James Gauderman; Rob McConnell; Edward Avol; John M Peters Journal: Am J Respir Crit Care Med Date: 2006-09-14 Impact factor: 21.405
Authors: Ramesh J Kurukulaaratchy; Abid Raza; Martha Scott; Paula Williams; Susan Ewart; Sharon Matthews; Graham Roberts; S Hasan Arshad Journal: Respir Med Date: 2011-12-31 Impact factor: 3.415
Authors: Patricia F Coogan; Nelsy Castro-Webb; Jeffrey Yu; George T O'Connor; Julie R Palmer; Lynn Rosenberg Journal: Am J Respir Crit Care Med Date: 2015-01-15 Impact factor: 21.405
Authors: Sabine Heinrich; Astrid Peters; Jessica Kellberger; Diana Ellenberg; Jon Genuneit; Dennis Nowak; Christian Vogelberg; Erika von Mutius; Gudrun Weinmayr; Katja Radon Journal: BMC Public Health Date: 2011-05-11 Impact factor: 3.295
Authors: Tania Maes; Sharen Provoost; Ellen A Lanckacker; Didier D Cataldo; Jeroen A J Vanoirbeek; Benoit Nemery; Kurt G Tournoy; Guy F Joos Journal: Respir Res Date: 2010-01-21
Authors: Demetris Lamnisos; Maria Moustaki; Ourania Kolokotroni; Huseyin Koksoy; Muharrem Faiz; Kenan Arifoglu; Donald K Milton; Nicos Middleton; Panayiotis K Yiallouros Journal: BMC Public Health Date: 2013-06-16 Impact factor: 3.295