Department of Paediatrics: Child and Youth Health, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
Thorax. 2012 Nov;67(11):941-9. doi: 10.1136/thoraxjnl-2011-200901. Epub 2012 Jun 12.
Exposure to parental smoking is associated with wheeze in early childhood, but in 2006 the US Surgeon General stated that the evidence is insufficient to infer a causal relationship between exposure and asthma in childhood and adolescents.
To examine the association between maternal and paternal smoking and symptoms of asthma, eczema and rhinoconjunctivitis.
Parents or guardians of children aged 6-7 years completed written questionnaires about symptoms of asthma, rhinoconjunctivitis and eczema, and several risk factors, including maternal smoking in the child's first year of life, current maternal smoking (and amount) and paternal smoking. Adolescents aged 13-14 years self completed the questionnaires on these symptoms and whether their parents currently smoked.
In the 6-7-year age group there were 220 407 children from 75 centres in 32 countries. In the 13-14-year age group there were 350 654 adolescents from 118 centres in 53 countries. Maternal and paternal smoking was associated with an increased risk of symptoms of asthma, eczema and rhinoconjunctivitis in both age groups, although the magnitude of the OR is higher for symptoms of asthma than the other outcomes. Maternal smoking is associated with higher ORs than paternal smoking. For asthma symptoms there is a clear dose relationship (1-9 cigarettes/day, OR 1.27; 10-19 cigarettes/day, OR 1.35; and 20+ cigarettes/day, OR 1.56). When maternal smoking in the child's first year of life and current maternal smoking are considered, the main effect is due to maternal smoking in the child's first year of life. There was no interaction between maternal and paternal smoking.
This study has confirmed the importance of maternal smoking, and the separate and additional effect of paternal smoking. The presence of a dose-response effect relationship with asthma symptoms suggests that the relationship is causal, however for eczema and rhinoconjunctivitis causality is less certain.
父母吸烟会导致儿童早期喘息，但 2006 年美国外科医生总检察长表示，现有证据不足以推断儿童和青少年时期暴露于吸烟环境与哮喘之间存在因果关系。
研究母亲和父亲吸烟与哮喘、湿疹和鼻结膜炎症状之间的关联。
6-7 岁儿童的父母或监护人填写了有关哮喘、鼻结膜炎和湿疹症状以及包括儿童生命最初一年母亲吸烟、当前母亲吸烟（和吸烟量）和父亲吸烟在内的若干风险因素的书面问卷。13-14 岁的青少年则自行填写了这些症状以及父母当前是否吸烟的问卷。
在 6-7 岁年龄组中，来自 32 个国家 75 个中心的 220407 名儿童参加了研究。在 13-14 岁年龄组中，来自 53 个国家 118 个中心的 350654 名青少年参加了研究。母亲和父亲吸烟与两个年龄组哮喘、湿疹和鼻结膜炎症状的风险增加有关，尽管与其他结果相比，哮喘症状的 OR 值更高。母亲吸烟与更高的 OR 值相关，而父亲吸烟则不然。对于哮喘症状，存在明显的剂量关系（1-9 支/天，OR1.27；10-19 支/天，OR1.35；20 支/天以上，OR1.56）。当考虑儿童生命最初一年的母亲吸烟和当前母亲吸烟时，主要作用归因于儿童生命最初一年的母亲吸烟。母亲和父亲吸烟之间没有交互作用。
本研究证实了母亲吸烟的重要性，以及父亲吸烟的单独和附加作用。与哮喘症状之间存在剂量-反应关系表明这种关系具有因果关系，但对于湿疹和鼻结膜炎，因果关系不太确定。
