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Download 20170117-The Effect of Cigarette Smoking on Lung Function in Young Adults.pdf
Judul The Effect of Cigarette Smoking on Lung Function in Young Adults with Asthma
Abstract Abstract
Rationale: Life-course persistent asthma and tobacco smoking are
risk factors for irreversible airflow obstruction. It is often assumed
that smoking and asthma have additive or multiplicative effects on
the risk for airflow obstruction, but this has not been demonstrated in
prospective studies of children with persistent asthma.
Objectives: To investigate the effects of smoking and asthma on the
development of airflow obstruction in a population-based birth
cohort followed to age 38 years.
Methods: Reports of childhood asthma from ages 9, 11, and 13 and
self-reports of adult asthma at ages 32 and 38 years were used to define
childhood-onset persistent asthma (n = 91), late-onset asthma
(n = 93), asthma in remission (n = 85), and nonasthmatic (n = 572)
phenotypes. Cumulative tobacco smoking histories and spirometry
were obtained at ages 18, 21, 26, 32, and 38 years. Analyses were by
generalized estimating equations adjusting for childhood spirometry,
body mass index, age, and sex.
Measurements and Main Results: Smoking history and
childhood-onset persistent asthma were both associated with
lower FEV1/FVC ratios. Associations between smoking and
FEV1/FVC ratios were different between asthma phenotypes
(interaction P,0.001). Smoking was associated with lower
prebronchodilator and post-bronchodilator FEV1/FVC ratios
among subjects without asthma and those with late-onset or
remittent asthma, but smoking was not associated with lower
FEV1/FVC ratios among those with childhood-onset persistent
asthma.
Conclusions: Childhood-onset persistent asthma is associated
with airflow obstruction by mid-adult life, but this does not
seem to be made worse by tobacco smoking. We found no
evidence that smoking and childhood-persistent asthma
have additive or multiplicative effects on airflow
obstruction.
Keywords: airway obstruction; chronic obstructive pulmonary
disease; cohort studies