Gilliland Frank D, Islam Talat, Berhane Kiros, Gauderman W James, McConnell Rob, Avol Edward, Peters John M
Department of Preventive Medicine, Keck School of Medicine of USC, 1540 Alcazar Street, CHP 236, Los Angeles, CA 90033, USA.
Am J Respir Crit Care Med. 2006 Nov 15;174(10):1094-100. doi: 10.1164/rccm.200605-722OC. Epub 2006 Sep 14.
Although involuntary exposure to maternal smoking during the in utero period and to secondhand smoke are associated with occurrence of childhood asthma, few studies have investigated the role of active cigarette smoking on asthma onset during adolescence.
To determine whether regular smoking is associated with the new onset of asthma during adolescence.
We conducted a prospective cohort study among 2,609 children with no lifetime history of asthma or wheezing who were recruited from fourth- and seventh-grade classrooms and followed annually in schools in 12 southern California communities. Regular smoking was defined as smoking at least seven cigarettes per day on average over the week before and 300 cigarettes in the year before each annual interview. Incident asthma was defined using new cases of physician-diagnosed asthma.
Regular smoking was associated with increased risk of new-onset asthma. Children who reported smoking 300 or more cigarettes per year had a relative risk (RR) of 3.9 (95% confidence interval [95% CI], 1.7-8.5) for new-onset asthma compared with nonsmokers. The increased risk from regular smoking was greater in nonallergic than in allergic children. Regular smokers who were exposed to maternal smoking during gestation had the largest risk from active smoking (RR, 8.8; 95% CI, 3.2-24.0).
Regular smoking increased risk for asthma among adolescents, especially for nonallergic adolescents and those exposed to maternal smoking during the in utero period.
尽管子宫内被动接触母亲吸烟以及接触二手烟与儿童哮喘的发生有关，但很少有研究调查主动吸烟在青少年哮喘发病中的作用。
确定经常吸烟是否与青少年哮喘的新发有关。
我们对2609名无哮喘或喘息病史的儿童进行了一项前瞻性队列研究，这些儿童从四年级和七年级教室招募，在南加州12个社区的学校中每年进行随访。经常吸烟定义为在每次年度访谈前一周平均每天至少吸7支烟，且在前一年吸300支烟。新发哮喘定义为医生诊断的哮喘新病例。
经常吸烟与新发哮喘风险增加有关。报告每年吸烟300支或更多的儿童患新发哮喘的相对风险（RR）为3.9（95%置信区间[95%CI]，1.7 - 8.5），而不吸烟者为1。与过敏儿童相比，非过敏儿童因经常吸烟导致的风险增加更大。孕期接触母亲吸烟的经常吸烟者因主动吸烟面临的风险最大（RR，8.8；95%CI，3.2 - 24.0）。
经常吸烟会增加青少年患哮喘的风险，尤其是对于非过敏青少年以及在子宫内接触母亲吸烟的青少年。
