Limits...
Greater severity of new onset asthma in allergic subjects who smoke: a 10-year longitudinal study.

Polosa R, Russo C, Caponnetto P, Bertino G, Sarvà M, Antic T, Mancuso S, Al-Delaimy WK - Respir. Res. (2011)

Bottom Line: Among these subjects, 74 (48.7%) were current smokers, 17 (11.2%) former smokers, and 61 (40.1%) never smokers.When comparing current or past smokers to never smokers they had a higher risk of severe asthma in the univariate analysis, which became non-significant in the multivariate analysis.On the other hand, the categories of pack-years were significantly related to severe asthma in a dose response relationship in both the univariate and multivariate analysis: compared to 0 pack years, those who smoked 1-10 pack-years had an OR(95% CI) of 1.47(0.46-4.68), those who smoked 11-20 pack-years had an OR of 2.85(1.09-7.46) and those who smoked more than 20 pack-years had an OR of 5.59(1.44-21.67) to develop more severe asthma.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dipartimento di biomedicina clinica e molecolare-S, Marta Hospital, azienda ospedaliero-universitaria O.V.E., Università di Catania, Catania, Italy. polosa@unict.it

ABSTRACT

Background: Little is known about the association between cigarette smoking and asthma severity. We assessed smoking as a determinant of disease severity and control in a cohort of clinic-referred allergic subjects who developed new onset asthma.

Methods: Allergic rhinitis subjects with no asthma (n = 371) were followed-up for 10 years and routinely examined for asthma diagnosis. In those who developed asthma (n = 152), clinical severity and levels of asthma control were determined. Among these subjects, 74 (48.7%) were current smokers, 17 (11.2%) former smokers, and 61 (40.1%) never smokers.

Results: When comparing current or past smokers to never smokers they had a higher risk of severe asthma in the univariate analysis, which became non-significant in the multivariate analysis. On the other hand, the categories of pack-years were significantly related to severe asthma in a dose response relationship in both the univariate and multivariate analysis: compared to 0 pack years, those who smoked 1-10 pack-years had an OR(95% CI) of 1.47(0.46-4.68), those who smoked 11-20 pack-years had an OR of 2.85(1.09-7.46) and those who smoked more than 20 pack-years had an OR of 5.59(1.44-21.67) to develop more severe asthma. Smokers with asthma were also more likely to have uncontrolled disease. A significant dose-response relationship was observed for pack-years and uncontrolled asthma. Compared to 0 pack years, those who smoked 1-10 pack-years had an OR of 5.51(1.73-17.54) and those who smoked more than 10 pack-years had an OR of 13.38(4.57-39.19) to have uncontrolled asthma.

Conclusions: The current findings support the hypothesis that cigarette smoking is an important predictor of asthma severity and poor asthma control.

Show MeSH

Related in: MedlinePlus

Study flow chart. Medical records of cases with allergic rhinitis in the period between January 1990 and December 1991 were reviewed. To be included in the study cases had to be between the ages of 18 and 40 years and not diagnosed with asthma. Out of the initial 371 cases, complete study outcomes variables were available from 325 subjects. A diagnosis of asthma could be established at final review (from January to April 2000) in 152 subjects. Among these subjects, 74 (48.7%) were current smokers, 17 (11.2%) former smokers, and 61 (40.1%) never smokers. Clinical severity class (circles) and level of asthma control (octagons) were then computed for each categorized smoking status.* At final review, asthma control data could not be calculated in 12 of those with new onset asthma due to lack of information about exacerbations.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3037316&req=5

Figure 1: Study flow chart. Medical records of cases with allergic rhinitis in the period between January 1990 and December 1991 were reviewed. To be included in the study cases had to be between the ages of 18 and 40 years and not diagnosed with asthma. Out of the initial 371 cases, complete study outcomes variables were available from 325 subjects. A diagnosis of asthma could be established at final review (from January to April 2000) in 152 subjects. Among these subjects, 74 (48.7%) were current smokers, 17 (11.2%) former smokers, and 61 (40.1%) never smokers. Clinical severity class (circles) and level of asthma control (octagons) were then computed for each categorized smoking status.* At final review, asthma control data could not be calculated in 12 of those with new onset asthma due to lack of information about exacerbations.

Mentions: Out of the initial 371 cases, study outcomes variables were available from 325 subjects (Figure 1). Data from 46 subjects were excluded from analyses for several reasons: a diagnosis of asthma could not be established with confidence (n = 39); occasional smokers (with a pack/yrs < 1) at baseline that never became regular smokers (n = 6); smoking history was missing (n = 1). At the final control visit, in the period from January 2000 to April 2000, a total of 152 subjects were found to have developed new onset asthma. Among these subjects, 74 (48.7%) were current smokers, 17 (11.2%) former smokers, and 61 (40.1%) never smokers. In 12 of those with new onset asthma at the final follow-up visit, asthma control data could not be calculated due to lack of information about exacerbations and were not included in the analyses relevant to that outcome. The study protocol was approved by the local institutional ethics and review board.


Greater severity of new onset asthma in allergic subjects who smoke: a 10-year longitudinal study.

Polosa R, Russo C, Caponnetto P, Bertino G, Sarvà M, Antic T, Mancuso S, Al-Delaimy WK - Respir. Res. (2011)

Study flow chart. Medical records of cases with allergic rhinitis in the period between January 1990 and December 1991 were reviewed. To be included in the study cases had to be between the ages of 18 and 40 years and not diagnosed with asthma. Out of the initial 371 cases, complete study outcomes variables were available from 325 subjects. A diagnosis of asthma could be established at final review (from January to April 2000) in 152 subjects. Among these subjects, 74 (48.7%) were current smokers, 17 (11.2%) former smokers, and 61 (40.1%) never smokers. Clinical severity class (circles) and level of asthma control (octagons) were then computed for each categorized smoking status.* At final review, asthma control data could not be calculated in 12 of those with new onset asthma due to lack of information about exacerbations.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3037316&req=5

Figure 1: Study flow chart. Medical records of cases with allergic rhinitis in the period between January 1990 and December 1991 were reviewed. To be included in the study cases had to be between the ages of 18 and 40 years and not diagnosed with asthma. Out of the initial 371 cases, complete study outcomes variables were available from 325 subjects. A diagnosis of asthma could be established at final review (from January to April 2000) in 152 subjects. Among these subjects, 74 (48.7%) were current smokers, 17 (11.2%) former smokers, and 61 (40.1%) never smokers. Clinical severity class (circles) and level of asthma control (octagons) were then computed for each categorized smoking status.* At final review, asthma control data could not be calculated in 12 of those with new onset asthma due to lack of information about exacerbations.
Mentions: Out of the initial 371 cases, study outcomes variables were available from 325 subjects (Figure 1). Data from 46 subjects were excluded from analyses for several reasons: a diagnosis of asthma could not be established with confidence (n = 39); occasional smokers (with a pack/yrs < 1) at baseline that never became regular smokers (n = 6); smoking history was missing (n = 1). At the final control visit, in the period from January 2000 to April 2000, a total of 152 subjects were found to have developed new onset asthma. Among these subjects, 74 (48.7%) were current smokers, 17 (11.2%) former smokers, and 61 (40.1%) never smokers. In 12 of those with new onset asthma at the final follow-up visit, asthma control data could not be calculated due to lack of information about exacerbations and were not included in the analyses relevant to that outcome. The study protocol was approved by the local institutional ethics and review board.

Bottom Line: Among these subjects, 74 (48.7%) were current smokers, 17 (11.2%) former smokers, and 61 (40.1%) never smokers.When comparing current or past smokers to never smokers they had a higher risk of severe asthma in the univariate analysis, which became non-significant in the multivariate analysis.On the other hand, the categories of pack-years were significantly related to severe asthma in a dose response relationship in both the univariate and multivariate analysis: compared to 0 pack years, those who smoked 1-10 pack-years had an OR(95% CI) of 1.47(0.46-4.68), those who smoked 11-20 pack-years had an OR of 2.85(1.09-7.46) and those who smoked more than 20 pack-years had an OR of 5.59(1.44-21.67) to develop more severe asthma.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dipartimento di biomedicina clinica e molecolare-S, Marta Hospital, azienda ospedaliero-universitaria O.V.E., Università di Catania, Catania, Italy. polosa@unict.it

ABSTRACT

Background: Little is known about the association between cigarette smoking and asthma severity. We assessed smoking as a determinant of disease severity and control in a cohort of clinic-referred allergic subjects who developed new onset asthma.

Methods: Allergic rhinitis subjects with no asthma (n = 371) were followed-up for 10 years and routinely examined for asthma diagnosis. In those who developed asthma (n = 152), clinical severity and levels of asthma control were determined. Among these subjects, 74 (48.7%) were current smokers, 17 (11.2%) former smokers, and 61 (40.1%) never smokers.

Results: When comparing current or past smokers to never smokers they had a higher risk of severe asthma in the univariate analysis, which became non-significant in the multivariate analysis. On the other hand, the categories of pack-years were significantly related to severe asthma in a dose response relationship in both the univariate and multivariate analysis: compared to 0 pack years, those who smoked 1-10 pack-years had an OR(95% CI) of 1.47(0.46-4.68), those who smoked 11-20 pack-years had an OR of 2.85(1.09-7.46) and those who smoked more than 20 pack-years had an OR of 5.59(1.44-21.67) to develop more severe asthma. Smokers with asthma were also more likely to have uncontrolled disease. A significant dose-response relationship was observed for pack-years and uncontrolled asthma. Compared to 0 pack years, those who smoked 1-10 pack-years had an OR of 5.51(1.73-17.54) and those who smoked more than 10 pack-years had an OR of 13.38(4.57-39.19) to have uncontrolled asthma.

Conclusions: The current findings support the hypothesis that cigarette smoking is an important predictor of asthma severity and poor asthma control.

Show MeSH
Related in: MedlinePlus