Differences in perceived sensitivity to air pollution between smokers and non-smokers during a heavy haze episode in Northeast China.

China experienced a catastrophic haze episode in January 2013 (2013JHE), no study has compared the prevalence of acute respiratory symptoms between smokers and non-smokers in 2013JHE. A rapid cross-sectional assessment of perceived air pollution and the prevalence of coughing, phlegm, and wheezing was conducted among 4303 adults sampled from three cities in Liaoning. Odds ratios (ORs) were calculated for the prevalence of coughing, phlegm, and wheezing. A path analysis was performed to test the relationships between number of cigarettes smoked daily, perceived air pollution score (PAPS), protective behavior score (PBS), and irritating feeling score (IFS). Among the participants, 26.3% felt irritated; 26.9% had acute respiratory symptoms; 22.9% had coughing; 20.2% had throat pain. The ORs for coughing, phlegm, and wheezing were all significantly increased among individuals with a history of respiratory disease, PAPS, PBS, and IFS. However, the ORs for coughing and wheezing were borderline significantly decreased among smokers, and the number of cigarettes smoked daily was negatively associated with PAPS and PBS in the path model. The 2013JHE had a serious impact local residents and significantly increased the prevalence of acute respiratory symptoms. Non-smokers and residents with a history of respiratory disease appear to be more susceptible sub-populations.