Cigarette smoking and the adult onset of bronchial asthma in Japanese men and women

doi:10.1016/S1081-1206(10)60333-X

Annals of Allergy, Asthma & Immunology

Volume 102, Issue 4, April 2009, Pages 288-293

https://doi.org/10.1016/S1081-1206(10)60333-X Get rights and content

Background

Although smoking is a well-known risk factor for the onset of airway diseases, the associations between smoking and asthma are inconsistent.

Objective

To examine the relationship of smoking in adulthood with the occurrence of asthma in Japanese individuals.

Methods

A total of 6,674 men and 8,301 women from a population-based cohort in Takayama, Japan, participated in this prospective study. Information on smoking was collected via a baseline questionnaire in 1992. In 2002, development of asthma and the time of physician diagnosis were reported.

Results

During 10-year follow-up, 105 men and 92 women reported the onset of physician-diagnosed asthma. Among men, compared with never smokers, current smokers at baseline had a significantly increased risk of asthma after adjustment for covariates (hazard ratio [HR], 2.79; 95% confidence interval [CI], 1.18–6.55), whereas women with a current or former history of smoking were at an increased but not significant risk of asthma (HR, 1.18; 95% CI, 0.58–2.38). An approximately 2- to 5-fold increased risk of asthma was observed in men who smoked for more than 30 years or more than 21 cigarettes daily, with a nonsignificant linear trend, but there was no dose-response relationship in current-smoking women. Ever-smoking women with husbands who were ever smokers had a higher risk of asthma (HR, 2.02; 95% CI, 0.72–5.65) than never-smoking women with husbands who had never smoked either.

Conclusion

These data suggest that smoking increases the risk of asthma onset in men.

Section snippets

INTRODUCTION

Smoking has been implicated as an etiological factor in airway diseases such as nasopharyngeal and lung cancers, chronic obstructive lung disease (COPD), and asthma.1, 2 One effect of smoking is alteration of the inflammatory response through the immunologic impact in the airways. The response in smokers is different from that in nonsmokers, which is that eosinophil numbers are reduced, whereas neutrophil numbers are raised in sputum from smokers. Furthermore, smoking is known to cause acute

Study Design and Population

Participants were from the Takayama Study, which is a population-based cohort study of men and women 35 years and older who resided in Takayama, Gifu. At baseline (1992), a self-administered questionnaire was given to 36,990 men and women. Participants were asked about their diet, sociodemographic status, anthropometric characteristics, past and current smoking status, quantity of regular physical activity, and medical history. The amount of regular physical activity was evaluated weekly

RESULTS

The characteristics of the population at the beginning of the study are given in Table 1. Participants with either current or former smoking experience at baseline tended to have a lower BMI and to consume more alcohol than never smokers. In women, participants with smoking experience tended to be younger and were less likely to be married than never smokers. Education of 15 years or more was nonsignificantly associated with smoking in men and women. In men, the metabolic equivalent score,

DISCUSSION

In this prospective, community-based study, we found that current smoking was significantly associated with an increased risk of asthma onset in men. Male former smokers had an increased risk of asthma, although this association was not statistically significant. An approximately 3- to 5-fold increased risk was observed in men who had smoked for more than 30 years or more than 20 cigarettes daily. These results indicate that active smoking increases the risk of asthma in men.

Female ever smokers

REFERENCES (22)

JH de Haas
Parental smoking: its effects on fetus and child health
Eur J Obstet Gynecol Reprod Biol
(1975)
F Rasmussen et al.
Impact of airway lability, atopy, and tobacco smoking on the development of asthma-like symptoms in asymptomatic teenagers
Chest
(2000)
RJ Troisi et al.
Cigarette smoking and incidence of chronic bronchitis and asthma in women
Chest
(1995)
SK Das
Harmful health effects of cigarette smoking
Mol Cell Biochem
(2003)
MS Benninger
The impact of cigarette smoking and environmental tobacco smoke on nasal and sinus disease: a review of the literature
Am J Rhinol
(1999)
NC Thomson et al.
Asthma and cigarette smoking
Eur Respir J
(2004)
JF Oliveti et al.
Pre- and perinatal risk factors for asthma in inner city African-American children
Am J Epidemiol
(1996)
C Infante-Rivard et al.
Maternal smoking and childhood asthma
Am J Epidemiol
(1999)
FD Gilliland et al.
Effects of maternal smoking during pregnancy and environmental tobacco smoke on asthma and wheezing in children
Am J Respir Crit Care Med
(2001)
R Alati et al.
In utero and postnatal maternal smoking and asthma in adolescence
Epidemiology
(2006)

I Suzuki et al.

Reliability and validity of a questionnaire and physical activity in epidemiological studies

J Epidemiol

(1998)

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Disclosures: Authors have nothing to disclose.

Funding Sources: This study was supported in part by a grant from the Ministry of Education, Culture, Sports, Science, and Technology, Japan.

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Original Articles: Asthma, Lower Airway DiseasesCigarette smoking and the adult onset of bronchial asthma in Japanese men and women

Background

Objective

Methods

Results

Conclusion

Section snippets

INTRODUCTION

Study Design and Population

RESULTS

DISCUSSION

Eur J Obstet Gynecol Reprod Biol

Chest

Chest

Harmful health effects of cigarette smoking

Mol Cell Biochem

The impact of cigarette smoking and environmental tobacco smoke on nasal and sinus disease: a review of the literature

Am J Rhinol

Asthma and cigarette smoking

Eur Respir J

Pre- and perinatal risk factors for asthma in inner city African-American children

Am J Epidemiol

Maternal smoking and childhood asthma

Am J Epidemiol

Effects of maternal smoking during pregnancy and environmental tobacco smoke on asthma and wheezing in children

Am J Respir Crit Care Med

In utero and postnatal maternal smoking and asthma in adolescence

Epidemiology

Reliability and validity of a questionnaire and physical activity in epidemiological studies

J Epidemiol

Original Articles: Asthma, Lower Airway Diseases
Cigarette smoking and the adult onset of bronchial asthma in Japanese men and women