Journal
INTERNATIONAL ARCHIVES OF ALLERGY AND IMMUNOLOGY
Volume 158, Issue 2, Pages 175-183Publisher
KARGER
DOI: 10.1159/000330900
Keywords
Asthma; Cigarette smoking; Epidemiology
Categories
Funding
- ECRHS I for centres in ECRHS II: Belgian Science Policy Office
- Ministere de la Sante, Glaxo France
- Insitut Pneumologique d'Aquitaine
- Contrat de Plan Etat-Region Languedoc-Rousillon
- CNMATS
- CNMRT [90MR/10, 91AF/6]
- Ministre delegue de la sante, RNSP, France
- GSF
- Bundesministerium fur Forschung und Technologie, Bonn, Germany
- Ministero dell'Universita e della Ricerca Scientifica e Tecnologica
- CNR
- Regione Veneto RSF Italy [381/05.93]
- Norwegian Research Council [101422/310]
- Dutch Ministry of Wellbeing, Public Health and Culture, The Netherlands
- Ministero Sanidad y Consumo Fondo de Investigaciones Santarias [91/0016060/00E-05E, 93/0393]
- Hospital General de Albacete
- Hospital General Juan Ramon Jimenez
- Consejeria de Sanidad Principado de Asturias, Spain
- Swedish Medical Research Council
- Swedish Heart Lung Foundation
- Swedish Association against Asthma and Allergy
- Swiss National Science Foundation [4026-28099]
- National Asthma Campaign
- British Lung Foundation
- Department of Health, South Thames Regional Health Authority, UK
- United States Department of Health, Education and Welfare Public Health Service [2 S07 RR05521-28]
- European Commission
- ECRHS II
- Albacete, Spain: Fondo de Investigaciones Santarias [97/0035-01, 99/0034-01, 99/0034-02]
- Hospital Universitario de Albacete, Consejeria de Sanidad
- Antwerp, Belgium: FWO (Fund for Scientific Research)-Flanders Belgium [G.0402.00]
- University of Antwerp
- Flemish Health Ministry
- Barcelona, Spain: SEPAR, Public Health Service [R01 HL62633-01]
- Fondo de Investigaciones Santarias [99/0034-02, 97/0035-01,99/0034-01]
- CIRIT [1999SGR 00241]
- Basel, Switzerland: Swiss National Science Foundation
- Swiss Federal Office for Education Science
- Swiss National Accident Insurance Fund (SUVA)
- Bergen, Norway: Norwegian Research Council, Norwegian Asthma & Allergy Association, Glaxo Wellcome AS, Norway Research Fund
- Erfurt, Germany: GSF - National Research Centre for Environment & Health, Deutsche Forschungsgemeinschaft [FR 1526/1-1]
- Hamburg, Germany: GSF - National Research Centre for Environment & Health, Deutsche Forschungsgemeinschaft [MA 711/4-1]
- Huelva, Spain: Fondo de Investigaciones Santarias [97/0035-01, 99/0034-01, 99/0034-02]
- Ministry of Health, Direction de la Recherche Clinique, CHU de Grenoble
- Ministere de l'Emploi et de la Solidarite, Direction Generale de la Sante, Aventis (France)
- Spain: Fondo de Investigaciones Santarias [97/0035-01, 99/0034-01, 99/0034-02]
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Background: The prevalence rates of smoking in subjects with asthma have frequently been reported as similar to those in the general population; however, available data are not up-to-date. There is only limited and somewhat conflicting information on the long-term effects of smoking on health outcomes among population-based cohorts of subjects with asthma. We aimed to investigate changes in smoking habits and their effects on forced expiratory volume in 1 s (FEV1) in subjects with asthma in comparison with the rest of the population, focusing on the healthy smoker effect. Methods: We studied 9,092 subjects without asthma and 1,045 with asthma at baseline who participated in both the European Community Respiratory Health Survey I (20-44 years old in 1991-1993) and 11 (1999-2002). Results: At follow-up, smoking was significantly less frequent among subjects with asthma than in the rest of the population (26 vs. 31%; p < 0.001). Subjects with asthma who were already ex-smokers at the beginning of the follow-up in the 1990s had the highest mean asthma score (number of reported asthma-like symptoms, range 0-5), probably as a result of the healthy smoker effect (2.80 vs. 2.44 in never smokers, 2.19 in quitters and 2.24 in smokers; p < 0.001). The influence of smoking on FEV1 decline did not depend on asthma status. Smokers had the highest proportion of subjects with chronic cough/phlegm (p < 0.01). Conclusion: One out of 4 subjects with asthma continues smoking and reports significantly more chronic cough and phlegm than never smokers and ex-smokers. This stresses the importance of smoking cessation in all patients with asthma, even in those with less severe asthma. Copyright (C) 2012 S. Karger AG, Basel
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