Van de Ven Monique O M, Engels Rutger C M E, Kerstjens Huib A M, Van den Eijnden Regina J J M
Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.
J Adolesc Health. 2007 Nov;41(5):444-54. doi: 10.1016/j.jadohealth.2007.05.015.
Several cross-sectional studies have showed higher smoking rates among adolescents with asthma, but hardly any study has investigated this relation longitudinally. This study examines whether these cross-sectional results are caused by higher smoking onset among adolescents with asthma, or by the development of asthma after smoking onset.
This was a longitudinal study (22 months) among 7,426 Dutch adolescents (mean age at baseline = 12.9 years). Asthma was assessed with self-report questionnaires of the International Study of Asthma and Allergies in Childhood (ISAAC) and the student questionnaire of the American College of Allergy, Asthma and Immunology. Adolescents' smoking and parental smoking were also assessed by adolescent-report. All analyses were controlled for age, gender, education, ethnicity, and parental smoking.
In baseline non-smokers, adolescents with current diagnosed asthma and with more severe asthma had an increased risk to become regular smokers. Among girls and adolescents with a smoking mother, having asthma symptoms was a risk factor for starting experimental smoking. In contrast, among boys and adolescents with a non-smoking mother, having asthma symptoms was protective for experimental smoking. With regard to the effect of smoking on asthma, adolescent smoking predicted a higher incidence of asthma symptoms. In addition, smoking predicted increased symptom severity scores, and this effect was stronger in girls. Adolescent smoking was a stronger predictor for the development of asthma symptoms when the mother smoked.
The relationship between asthma and smoking in adolescence seems to be bidirectional, with relations in both directions being stronger in females and when the mother smokes.
多项横断面研究表明，哮喘青少年的吸烟率较高，但几乎没有研究对这种关系进行纵向调查。本研究旨在探讨这些横断面研究结果是由哮喘青少年较高的吸烟起始率导致的，还是由吸烟起始后哮喘的发生所导致的。
这是一项针对7426名荷兰青少年（基线平均年龄 = 12.9岁）的纵向研究（为期22个月）。哮喘通过儿童哮喘和过敏国际研究（ISAAC）的自我报告问卷以及美国过敏、哮喘与免疫学会的学生问卷进行评估。青少年的吸烟情况和父母的吸烟情况也通过青少年报告进行评估。所有分析均对年龄、性别、教育程度、种族和父母吸烟情况进行了控制。
在基线时不吸烟的青少年中，当前被诊断患有哮喘且哮喘病情较严重的青少年成为经常吸烟者的风险增加。在女孩和母亲吸烟的青少年中，有哮喘症状是开始尝试吸烟的一个风险因素。相比之下，在男孩和母亲不吸烟的青少年中，有哮喘症状对尝试吸烟具有保护作用。关于吸烟对哮喘的影响，青少年吸烟预示着哮喘症状的更高发病率。此外，吸烟预示着症状严重程度评分增加，且这种影响在女孩中更强。当母亲吸烟时，青少年吸烟是哮喘症状发展的更强预测因素。
青春期哮喘与吸烟之间的关系似乎是双向的，在女性以及母亲吸烟的情况下，两个方向的关系都更强。
