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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.

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Related in: MedlinePlus

Percentage of subjects with less severe (GINA Step I and II; white bars) and more severe (GINA Step III and IV; grey bars) forms of asthma among the non-smokers and those who smoked. Estimation of the amount and duration of smoking exposure was established by calculating pack-years. Smokers were therefore categorized by incremental pack-years.
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Figure 2: Percentage of subjects with less severe (GINA Step I and II; white bars) and more severe (GINA Step III and IV; grey bars) forms of asthma among the non-smokers and those who smoked. Estimation of the amount and duration of smoking exposure was established by calculating pack-years. Smokers were therefore categorized by incremental pack-years.

Mentions: Smokers had a higher risk of severe asthma with a significant dose-response relationship (Chisq = 11.63, p = 0.009). Our results indicate that 25.6% (20/78) of non smokers developed a severe form of asthma (GINA Steps III + IV), and similarly only 25% (6/24) of those who smoked 1-10 pack years developed a severe form of the disease compared to 47.1% (16/34) of those who smoked 11-20 pack years developed a severe form of asthma and even a higher percentage (62.5%; 10/16) of severe asthma cases were identified in those who smoked more than 20 pack years (Figure 2).


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)

Percentage of subjects with less severe (GINA Step I and II; white bars) and more severe (GINA Step III and IV; grey bars) forms of asthma among the non-smokers and those who smoked. Estimation of the amount and duration of smoking exposure was established by calculating pack-years. Smokers were therefore categorized by incremental pack-years.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Percentage of subjects with less severe (GINA Step I and II; white bars) and more severe (GINA Step III and IV; grey bars) forms of asthma among the non-smokers and those who smoked. Estimation of the amount and duration of smoking exposure was established by calculating pack-years. Smokers were therefore categorized by incremental pack-years.
Mentions: Smokers had a higher risk of severe asthma with a significant dose-response relationship (Chisq = 11.63, p = 0.009). Our results indicate that 25.6% (20/78) of non smokers developed a severe form of asthma (GINA Steps III + IV), and similarly only 25% (6/24) of those who smoked 1-10 pack years developed a severe form of the disease compared to 47.1% (16/34) of those who smoked 11-20 pack years developed a severe form of asthma and even a higher percentage (62.5%; 10/16) of severe asthma cases were identified in those who smoked more than 20 pack years (Figure 2).

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