Combined effects of parental and active smoking on early lung function deficits: a prospective study from birth to age 26 years

Abstract

Background Cross-sectional reports have suggested that, among active smokers, previous exposure to parental smoking may increase susceptibility to development of chronic obstructive pulmonary disease. We assessed prospectively whether parental smoking enhances the effects of active smoking on early deficits of lung function in young adults. Methods We used data from the prospective birth cohort, the Tucson Children’s Respiratory Study. Maternal and paternal smoking was assessed via questionnaires completed by the parents at the time of the participant’s birth. Active smoking by participants was assessed via personal questionnaires completed at ages 16 (YR16), 22, and 26 years. Four groups were generated based on the combination of parental smoking at the time of child’s birth and active smoking reported at YR16, YR22, or YR26. Lung function parameters, including FEV1/FVC ratio, were assessed by spirometry before and after inhalation of 180 µg of albuterol at YR11, YR16, YR22, and YR26. Results Complete data were available for 519 participants. Pre-bronchodilator FEV1/FVC values did not differ at YR11, YR16, or YR22 by parental or active smoking. However, at YR26 participants with exposure to both parental and active smoking had pre-bronchodilator FEV1/FVC levels that were, on average 2.8% (0.9%–4.8%; p=0.003) lower than participants who were not exposed to either. In contrast, subjects who were only exposed to active smoking or only exposed to parental smoking did not differ from those who were not exposed to either. Between YR11 and YR26, participants with exposure to both parental and active smoking had the steepest decline in sex-, age-, and height-adjusted residuals of FEV1/FVC, FEV1, FEF25–75, and FEF25–75/FVC (all p values between 0.03 and <0.001). Conclusions Parental and active smoking act synergistically to affect early lung function deficits in young adulthood.

The association between environmental tobacco smoke exposure and childhood respiratory disease: a review

“…Follow-up of participants from the Tucson Children’s Respiratory birth cohort study through first 26 years of life has demonstrated that ETS exposure in utero and during early life increases the susceptibility to the harmful effects of active smoking in early adulthood and an accelerated decline in lung function [67]. …”

“…Maternal smoking reduces infant lung function which is associated with impaired lung volume in adulthood (both for FEV1 and forced vital capacity (FVC)), independent of smoking in adulthood, compounding the effect of smoking to reduce airflow limitation and increasing the risk of COPD [92]. Parental smoking was also responsible for a rapid decline in FEV1:FVC ratio in young adulthood even more (3%) than that of smokers not exposed to parental smoke [67]. The majority of studies focused on airflow limitation (FEV1 and FEV1:FVC) as a marker of ETS-exposure-related airway obstruction [92].…”

Association between asthma and lung function in adolescents born very preterm: results of the EPIPAGE cohort study

“…Aside from anatomical origins, several studies argue for the additive role of dynamic processes in the airways of preterm-born subjects, with on-going disease, that may be induced by preterm birth per se and postnatal environmental factors 11. Lifelong environmental factors may have a deleterious synergistic effect, like environmental tobacco smoke exposure in infancy and later active smoking 12. Here, we provide arguments for an independent impact of a postnatal clinical factor, preschool wheeze, on alterations of lung function in preterm-born subjects at adolescence.…”

Early-life origins of chronic respiratory diseases: understanding and promoting healthy ageing

“…The previously mentioned meta-analysis of 79 prospective studies found an 18-70% higher incidence of wheezing in children exposed to postnatal maternal smoking (OR 1.70 in children f2 years of age) [42]. Prospective birth cohort studies following children up to adult age showed a persistence of the harmful effects of prenatal and postnatal tobacco smoke exposure [46][47][48][49]. In a birth cohort of 1314 children from Germany, maternal smoking during pregnancy almost doubled the risk of asthma at the age of 20 years [49].…”