Interaction between asthma and smoking increases the risk of adult airway obstruction
Open accessAbstract
The aim of the present study was to analyse the interaction between asthma and smoking in the risk of adult airway obstruction, accounting for atopy. In the European Community Respiratory Health Survey, 15 668 persons aged 20-56 years underwent spirometry in 1991-1993 and 9 years later (n=8916). Risk of airway obstruction and lung function decline associated with smoking and early-onset (<10 years of age) and late-onset (>10 years of age) asthma were analysed with generalised estimating equation models and random-effect linear models, adjusting for covariates. Interaction of asthma with smoking was expressed as relative excess risk due to interaction (RERI). A 20-fold increase in adult airway obstruction was found among those with early-onset asthma independently of smoking status (never-smokers: OR 21.0, 95% CI 12.7-35; current smokers: OR 23.7, 95% CI 13.9-40.6). Late-onset asthma was associated with airway obstruction, with a stronger association among current smokers (OR 25.6, 95% CI 15.6-41.9) than among never-smokers (OR 11.2, 95% CI 6.8-18.6) (RERI 12.02, 95% CI 1.96-22.07). Stratifying by atopy, the association between smoking and asthma was most pronounced among nonatopics. Early- and late-onset asthma were associated with 10-20-fold increased risk of adult airway obstruction. Smoking increased the risk of adult airway obstruction in subjects with asthma onset after age 10 years. Investigation of measures potentially preventive of chronic obstructive pulmonary disease development following asthma is urgently needed.
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The effect of early onset asthma on reduction in lung function and fixed airflow obstruction at 45 years was greater than late onset asthma.
“It has been shown that both early and late onset adult current asthma were associated with a reduction in lung function and an increased risk of fixed airflow obstruction at 45 years, with the effect of early onset asthma being greater than late onset asthma (165–167).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [167]
Lung function deficits in those with early onset adult asthma may result from both the tracking of reduced lung function from childhood and additional loss from a greater rate of decline in adulthood.
“Lung function deficits in those with early onset adult asthma may result from both the tracking of reduced lung function from childhood and additional loss from a greater rate of decline in adulthood (167, 171).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [167]
The decline associated with early onset adult asthma is greater than that with late onset adult asthma.
“While both early and late onset adult asthma seem to be associated with faster lung function decline, the decline associated with early onset adult asthma is greater than that with late onset adult asthma (167).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [167]
Both early and late onset adult current asthma were associated with a reduction in lung function and an increased risk of fixed airflow obstruction at 45 years.
“It has been shown that both early and late onset adult current asthma were associated with a reduction in lung function and an increased risk of fixed airflow obstruction at 45 years, with the effect of early onset asthma being greater than late onset asthma (165–167).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [167]
Both early and late onset adult asthma seem to be associated with faster lung function decline.
“While both early and late onset adult asthma seem to be associated with faster lung function decline, the decline associated with early onset adult asthma is greater than that with late onset adult asthma (167).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [167]
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References 46 · Cited by 84
Research works printed but not linked: 1
- Mannino DM. COPD: epidemiology, prevalence, morbidity and mortality, and disease heterogeneity. Chest 2002; 121: 121S-126S.
- Authors
- Aanerud, M., Carsin, A.-E., Sunyer, J., Dratva, J., Gislason, T., Jarvis, D., deMarco, R., Raherison, C., Wjst, M., Dharmage, S. C., & Svanes, C.
- Affiliations
- Haukeland University Hospital (NO)
- Center for Research in Environmental Epidemiology (ES)
- Universitat Pompeu Fabra (ES)
- Swiss Tropical and Public Health Institute (CH)
- Imperial College London (GB)
- University of Verona (IT)
- Helmholtz Munich (DE)
- The University of Melbourne (AU)
- ORCID
- Venue
- European Respiratory Journal
- Publisher
- European Respiratory Society (ERS)
- Published
- 2014-11-27
- Volume
- 45
- Issue
- 3
- Pages
- 635-643
- ISSN
- 0903-1936 (ISSN-L)
- 1399-3003
- OpenAlex
- W2004783173
- Cited by
- 84
- References
- 46
- Citations by year
- 2025: 5 · 2024: 4 · 2023: 8 · 2022: 6 · 2021: 7 · 2020: 10 · 2019: 8 · 2018: 10 · 2017: 7 · 2016: 9 · 2015: 10
- FWCI
- 5.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Respiratory Journal (publishedVersion)
- PubMed (publishedVersion)
- Site cant be reached (submittedVersion)
- PuSH - Publication Server of Helmholtz Zentrum München (submittedVersion)
- Hirsla (Landspítali University Hospital) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Physiology › Smoking Behavior and Cessation
- Keywords
- asthma, smoking, airway obstruction, lung function decline, atopy, early-onset asthma, late-onset asthma, chronic obstructive pulmonary disease, spirometry
- MeSH terms
- Adult, Age Factors, Airway Obstruction, Asthma, Europe, Female, Health Surveys, Humans, Male, Middle Aged, Prognosis, Respiratory Function Tests, Risk Factors, Sex Factors, Smoking, Reproducibility of Results, Linear Models, Age of Onset, Risk Assessment
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