Critical age windows in the impact of lifetime smoking exposure on respiratory symptoms and disease among ever smokers

Erbas, Bircan; Knudsen, Toril Mørkve; Janson, Christer; Nilsen, Roy Miodini; Accordini, Simone; Benediktdottir, Bryndis; Dratva, Julia; Heinrich, Joachim; Jarvis, Déborah; Leynaert, Bénédicte; Matheson, Melanie C.; Norbäck, Dan; Real, Francisco Gómez; Raherison‐Semjen, Chantal; Villani, Simona; Dharmage, Shyamali C.; Svanes, Cecilie

doi:10.1016/j.envres.2018.02.028

Cited by 13 publications

(14 citation statements)

References 31 publications

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“…Table 1 summarizes the characteristics of each study. The association between risk of adult COPD and childhood serious respiratory infections, pneumonia or bronchitis was reported in 14 studies 6,7,15,16,[20][21][22][23][24][25][26][27][28]50 ; childhood asthma in nine studies 8,15,16,20,28,[34][35][36][37] ; maternal smoking in seven studies 6,15,18,19,23,37,41,51 ; CETS in two studies 40,41 ; child maltreatment in five studies [29][30][31][32][33] ; low birth weight in three studies 6,23,39 ; and premature birth in three studies. 23,28,39 Included participants were older than 40 years, except for studies from the European Community Respiratory Health Survey, in which the average age was about 36 years.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

“…23,28,39 Included participants were older than 40 years, except for studies from the European Community Respiratory Health Survey, in which the average age was about 36 years. 8,26,51 The study population of five studies was eversmokers 21,23,34,41,51 and two studies included neversmokers. 6,7 Table S1 in the Supporting Information shows the assessment of article quality.…”

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

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Impact of early life exposures on COPD in adulthood: A systematic review and meta‐analysis

et al. 2021

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Early life represents a critical period for the development and growth of the lungs. Adverse exposures in this stage may drive the development of chronic obstructive pulmonary disease (COPD). Thus, we quantitatively evaluated the impact of different early life exposures on COPD in adulthood. The PubMed, Embase and Cochrane Library electronic databases were searched for articles published from January 2001 to October 2020. A total of 30 studies (795,935 participants) met the criteria and were included in the review. We found a significant association of COPD with childhood serious respiratory infections, pneumonia or bronchitis (pooled adjusted OR [aOR], 2.23 [95% CI, 1.63-3.07]). The probability of COPD was increased 3.45-fold for children with than without asthma (pooled aOR, 3.45 [95% CI, 2.37-5.02]). In addition, the probability of COPD was associated with maternal smoking (pooled aOR, 1.42 [95% CI, 1.17-1.72]), any child maltreatment (pooled aOR, 1.30 [95% CI, 1.18-1.42]) and low birth weight (pooled aOR, 1.58 [95% CI, 1.08-2.32]) but not childhood environmental tobacco smoke exposure (pooled aOR,) or premature birth (pooled aOR, 1.17 [95% CI, 0.87-1.58]). Furthermore, subgroup analyses revealed that probability was increased for only women with childhood physical abuse, sexual abuse and exposure to intimate partner violence. Factors resulting in COPD in adults could trace back to early life. Childhood respiratory disease, maltreatment, maternal smoking and low birth weight increase the risk of COPD. Promising advances in prevention strategies for early life exposures could markedly decrease the risk of COPD.K E Y W O R D S chronic obstructive pulmonary disease, COPD in adulthood, early life exposure, risk factor, systematic review and meta-analysis

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Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Section: Characteristics Of the Included Studiesmentioning

confidence: 99%

Impact of early life exposures on COPD in adulthood: A systematic review and meta‐analysis

et al. 2021

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“…The smoking population underestimates their respiratory symptoms; however, exercise activity is many times reduced. Therefore, to detect new COPD cases, questions related to respiratory vulnerability and deconditioning are required 27,35 . Besides, recent studies showed that exacerbations are frequent in smokers, even they had normal spirometry tests.…”

Section: Discussionmentioning

confidence: 99%

Underestimation of respiratory symptoms by smokers: a thorn in chronic obstructive pulmonary disease diagnosis

Gogou

Kotsiou

Siachpazidou

et al. 2021

npj Prim. Care Respir. Med.

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Primary care centers are ideal positions to identify chronic obstructive pulmonary disease (COPD). We determined the COPD prevalence among ever-smokers aged 40–65 years attending a 2-year program conducted in 22 Greek primary healthcare centers and made comparisons between genders, patients less than or greater than 55 years, and newly or previously diagnosed COPD patients. A total of 117 persons, after studying 1100 people, were diagnosed with previously unknown or known COPD, providing a COPD prevalence of 10.6% among the study population. In all, 7.5% of the participants were newly diagnosed with COPD. Women with COPD reported smoking less but experienced worse respiratory and depressive symptoms than men. A total of 19% of the COPD population below 55 years experienced wheezing and exacerbations more frequently than older patients. Newly diagnosed COPD patients were significantly younger, reported a significant burden of symptoms without seeking medical help. Primary health care has a crucial role in the early detection of COPD among unsuspecting smokers.

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“…As described in a systematic review covering 16 studies of 69,365 individuals, tobacco exposure in utero and early life represents an important risk factor for development of COPD in adulthood ( Savran and Ulrik, 2018 ). In addition, among ever smokers, people with an early age of smoking debut appeared to be more vulnerable to pulmonary respiratory symptoms ( Erbas et al, 2018 ). Cigarette smoking has also been shown to augment the adverse effects of early life exposures (infant respiratory infection and home overcrowding) ( Allinson et al, 2017 ) on mid life FEV1 and FVC.…”

Section: Well-established Risk Factorsmentioning

confidence: 99%

More to Explore: Further Definition of Risk Factors for COPD – Differential Gender Difference, Modest Elevation in PM2.5, and e-Cigarette Use

et al. 2021

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Chronic obstructive pulmonary disease (COPD) is a severe respiratory disease with high morbidity and mortality, representing the third leading cause of death worldwide. Traditional risk factors for COPD include aging, genetic predisposition, cigarette smoking, exposure to environmental pollutes, occupational exposure, and individual or parental respiratory disease history. In addition, latest studies have revealed novel and emerging risk factors. In this review, differential gender difference as a factor for COPD development at different territories is discussed for the first time. First, women seem to have more COPD, while more women die of COPD or have more severe COPD, in Western societies. This seems different from the impression that COPD dominants in men, which is true in Eastern societies. It might be related to higher rate of cigarette smoking in women in developed countries (i.e., 12.0% of women in United States smoke vs. 2.2% in China). Nonetheless, women in Eastern societies are exposed to more biomass usage. Second, modest elevation in PM2.5 levels at >∼21.4–32.7 μg/m3, previously considered “cleaner air,” is associated with incidence of COPD, indicating that more stringent goals should be set for the reduction of PM2.5 levels to prevent COPD development. Last but not least, e-cigarette use, which has become an epidemic especially among adolescents as officially declared by the United States government, has severe adverse effects that may cause development of COPD early in life. Built upon an overview of the established risk factors for COPD primarily focusing on cigarette smoking and environmental pollutions, the present review further discusses novel concepts, mechanisms, and solutions evolved around the emerging risk factors for COPD discussed above, understanding of which would likely enable better intervention of this devastating disease.

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Critical age windows in the impact of lifetime smoking exposure on respiratory symptoms and disease among ever smokers

Abstract: Among ever smokers, smoking exposure in each stage of the lifespan show persistent harmful effects for adult respiratory health, while women appeared to be more vulnerable to an early age of smoking debut and amount of smoking in adulthood.

Cited by 13 publications

References 31 publications

Impact of early life exposures on COPD in adulthood: A systematic review and meta‐analysis

Impact of early life exposures on COPD in adulthood: A systematic review and meta‐analysis

Underestimation of respiratory symptoms by smokers: a thorn in chronic obstructive pulmonary disease diagnosis

More to Explore: Further Definition of Risk Factors for COPD – Differential Gender Difference, Modest Elevation in PM2.5, and e-Cigarette Use

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