Critical age windows in the impact of lifetime smoking exposure on respiratory symptoms and disease among ever smokers

Despite extensive knowledge of smoking effects on respiratory disease, there is no study including all age windows of exposure among ever smokers. The objective of this study was to assess the effects from smoking exposure in utero, early childhood, adolescence and adulthood on respiratory health ou...

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Bibliographic Details
Published in:	Environmental research Vol. 164; pp. 241 - 247
Main Authors:	Erbas, Bircan, Knudsen, Toril Mørkve, Janson, Christer, Nilsen, Roy M., Accordini, Simone, Benediktdottir, Bryndis, Dratva, Julia, Heinrich, Joachim, Jarvis, Debbie, Leynaert, Benedcite, Matheson, Melanie C., Norbäck, Dan, Real, Francisco G., Raherison-Semjen, Chantal, Villani, Simona, Dharmage, S.C., Svanes, C.
Format:	Journal Article
Language:	English
Published:	Netherlands Elsevier Inc 01-07-2018
Subjects:	Adolescent Adult Asthma Asthma - epidemiology Child Child, Preschool Cigarette smoking ECRHS Female Humans Lung function Male Maternal Exposure Pulmonary Disease, Chronic Obstructive - epidemiology Respiratory Sounds Respiratory symptoms Risk Factors Smokers Smoking - adverse effects FVC ECRHS Lung function Respiratory symptoms FEV1 Cigarette smoking BHR GAMMs COPD LLN Asthma
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Summary:	Despite extensive knowledge of smoking effects on respiratory disease, there is no study including all age windows of exposure among ever smokers. The objective of this study was to assess the effects from smoking exposure in utero, early childhood, adolescence and adulthood on respiratory health outcomes in adult male and female ever smokers. Respiratory health outcomes were assessed in 10,610 participants of the European Community Respiratory Health Survey (ECRHS) I who reported a history of ever smoking by questionnaire. The associations of maternal smoking in utero, maternal smoking during childhood, age of smoking debut and pack-years of smoking with respiratory symptoms, obstructive diseases and bronchial hyperreactivity were analysed using generalized linear regression, non-linearity between age of smoking debut and outcomes were assessed by Generalized additive mixed models. Respiratory symptoms and asthma were more frequent in adults if their mother smoked during pregnancy, and, in men, also if mother smoked in childhood. Wheeze and ≥3 respiratory symptoms declined with later smoking debut among women [≤10 years: OR = 3.51, 95% CI 1.26, 9.73; 11–12 years: 1.57[1.01–2.44]; 13–15 years: 1.11[0.94–1.32] and ≤10 years: 3.74[1.56–8.83]; 11–12 years: 1.76[1.19–2.56]; 13–15 years: 1.12[0.94–1.35], respectively]. Effects of increasing number of packyears were pronounced in women (Chronic Obstructive Pulmonary Disease (COPD): OR/10 packyears women: 1.33 [1.18, 1.50], men: 1.14 [1.04, 1.26] pinteraction = 0.01). Among ever smokers, smoking exposure in each stage of the lifespan show persistent harmful effects for adult respiratory health, while women appeared to be more vulnerable to an early age of smoking debut and amount of smoking in adulthood. •Smoking exposure in utero, childhood, adolescence and adulthood were related to respiratory symptoms in adult ever smokers.•Gender differences in response to in utero and post-natal smoking exposure were not pronounced.•Women were more vulnerable than men to early smoking debut in adolescence and to smoking an increasing number of pack-years.
ISSN:	0013-9351 1096-0953 1096-0953
DOI:	10.1016/j.envres.2018.02.028