Gold D R, Wang X, Wypij D, Speizer F E, Ware J H, Dockery D W
Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA.
N Engl J Med. 1996 Sep 26;335(13):931-7. doi: 10.1056/NEJM199609263351304.
Little is known about the sex-specific effects of cigarette smoking on the level and growth of lung function in adolescence, when 71 percent of people in the United States who smoke tried their first cigarette.
We studied the effects of cigarette smoking on the level and rate of growth of pulmonary function in a cohort of 5158 boys and 4902 girls 10 to 18 years of age, examined annually between 1974 and 1989 in six cities in the United States.
We found a dose-response relation between smoking and lower levels of both the ratio of forced expiratory volume in one second to forced vital capacity (FEB1/FVC) and the forced expiratory flow between 25 and 75 percent of FVC (FEF25-75). Each pack per day of smoking was associated with a 3.2 percent reduction in FEF25-75 for girls (P=0.01) and a 3.5 percent reduction in FEF25-75 for boys (P=0.007). Whereas the FVC level was elevated in smokers, the rate of growth of FVC and FEV1 was reduced. Among adolescents of the same sex, smoking five or more cigarettes a day, as compared with never smoking, was associated with 1.09 percent slower growth of FEV1 per year in girls (95 percent confidence interval 0.70 to 1.47) and 0.20 percent slower growth in boys (95 percent confidence interval, -0.16 to 0.56), and with 1.25 percent slower growth of FEF25-75 per year in girls (95 percent confidence interval 0.38 to 2.13) and 0.93 percent slower growth in boys (95 percent confidence interval, 0.21 to 1.65). Whereas girls who did not smoke reached a plateau of lung function at 17 to 18 years of age, girls of the same age who smoked had a decline of FEV1 and FEF25-75.
Cigarette smoking is associated with evidence of mild airway obstruction and slowed growth of lung function in adolescents. Adolescent girls may be more vulnerable than boys to the effects of smoking on the growth of lung function.
在美国，71% 的吸烟者在青少年时期就开始尝试吸第一支烟，但关于吸烟对青少年肺功能水平和生长的性别特异性影响，我们所知甚少。
我们在美国六个城市对5158名男孩和4902名10至18岁的女孩进行了一项队列研究，研究吸烟对肺功能水平和生长速率的影响，研究时间为1974年至1989年，每年进行检查。
我们发现吸烟与一秒用力呼气容积与用力肺活量之比（FEV1/FVC）以及FVC的25%至75%之间的用力呼气流量（FEF25-75）水平降低之间存在剂量反应关系。女孩每天每多吸一包烟，FEF25-75就降低3.2%（P=0.01），男孩则降低3.5%（P=0.007）。虽然吸烟者的FVC水平有所升高，但FVC和FEV1的生长速率却降低了。在同性别的青少年中，每天吸五支或更多香烟的人与从不吸烟的人相比，女孩的FEV1每年生长速度慢1.09%（95%置信区间为0.70至1.47），男孩慢0.20%（95%置信区间为-0.16至0.56），女孩的FEF25-75每年生长速度慢1.25%（95%置信区间为0.38至2.13），男孩慢0.93%（95%置信区间为0.21至1.65）。不吸烟的女孩在17至18岁时肺功能达到平稳状态，而同龄吸烟女孩的FEV1和FEF25-75则下降。
吸烟与青少年轻度气道阻塞及肺功能生长缓慢的证据有关。青少年女孩可能比男孩更容易受到吸烟对肺功能生长影响的伤害。
