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EFFECTS OF SMOKING ON LUNG FUNCTION AMONG CHILDREN AND ADOLESCENTS

Abstract

Passive smoking, especially of maternal origin, is known to influence adversely the development of children’s pulmonary function. In this study, the effect of parental smoking on the pulmonary function of 360 primary school children aged 9–13 (mean 10.8±0.7) years was investigated. Information on parental smoking history was collected using a questionnaire, and spirometric measurements were performed on the children.

All spirometric indices were lower in children who had been passively exposed to parental tobacco smoke than those not exposed. The percentage of households in which at least one parent smoked was 81.5%. This figure was significantly lower for mothers (27.5%) than for fathers (79%). Paternal smoking was associated with reduced levels of forced expiratory flow between 25–75% of vital capacity, peak expiratory flow, and flow rates after 50% and 75% of vital capacity expired (p<0.05). Maternal smoking did not have statistically significant adverse effects on children’s pulmonary function. This result might be due to the low occurrence of either pre- or post-natal smoking among mothers and confirms that, in our population, the main target group for anti-tobacco campaigns should be fathers.

Effects of Cigarette Smoking on Lung Function in Adolescent Boys and Girls

List of authors.

Diane R. Gold, M.D., M.P.H., Xiaobin Wang, M.D., Sc.D., David Wypij, Ph.D., Frank E. Speizer, M.D., James H. Ware, Ph.D., and Douglas W. Dockery, Sc.D.

Article

Figures/Media

29 References

348 Citing Articles

Abstract

BACKGROUND

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.

METHODS

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.

RESULTS

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 (FEV1/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 percent) and 0.20 percent slower growth in boys (95 percent confidence interval, -0.16 to 0.56 percent), and with 1.25 percent slower growth of FEF25–75 per year in girls (95 percent confidence interval, 0.38 to 2.13 percent) and 0.93 percent slower growth in boys (95 percent confidence interval, 0.21 to 1.65 percent). Whereas girls who did not smoke reached a plateau in lung function at 17 to 18 years of age, girls of the same age who smoked had a decline of FEV1 and FEF25–75.

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