Second-hand smoke exposure in adulthood and lower respiratory health during 20 year follow up in the European Community Respiratory Health Survey

Abstract

Background Early life exposure to tobacco smoke has been extensively studied but the role of second-hand smoke (SHS) for new-onset respiratory symptoms and lung function decline in adulthood has not been widely investigated in longitudinal studies. Our aim is to investigate the associations of exposure to SHS in adults with respiratory symptoms, respiratory conditions and lung function over 20 years. Methods We used information from 3011 adults from 26 centres in 12 countries who participated in the European Community Respiratory Health Surveys I-III and were never or former smokers at all three surveys. Associations of SHS exposure with respiratory health (asthma symptom score, asthma, chronic bronchitis, COPD) were analysed using generalised linear mixed-effects models adjusted for confounding factors (including sex, age, smoking status, socioeconomic status and allergic sensitisation). Linear mixed-effects models with additional adjustment for height were used to assess the relationships between SHS exposure and lung function levels and decline. Results Reported exposure to SHS decreased in all 26 study centres over time. The prevalence of SHS exposure was 38.7% at baseline (1990–1994) and 7.1% after the 20-year follow-up (2008–2011). On average 2.4% of the study participants were not exposed at the first, but were exposed at the third examination. An increase in SHS exposure over time was associated with doctor-diagnosed asthma (odds ratio (OR): 2.7; 95% confidence interval (95%-CI): 1.2–5.9), chronic bronchitis (OR: 4.8; 95%-CI: 1.6–15.0), asthma symptom score (count ratio (CR): 1.9; 95%-CI: 1.2–2.9) and dyspnoea (OR: 2.7; 95%-CI: 1.1–6.7) compared to never exposed to SHS. Associations between increase in SHS exposure and incidence of COPD (OR: 2.0; 95%-CI: 0.6–6.0) or lung function (β: − 49 ml; 95%-CI: -132, 35 for FEV 1 and β: − 62 ml; 95%-CI: -165, 40 for FVC) were not apparent. Conclusion Exposure to second-hand smoke may lead to respiratory symptoms, but this is not accompanied by lung function changes. Electronic supplementary material The online version of this article (10.1186/s12931-019-0996-z) contains supplementary material, which is available to authorized users.

The relation of environmental tobacco smoke (ETS) to chronic bronchitis and mortality over two decades

“…In the present study, the prevalence of subjects exposed to ETS in 2012 was 5%, which is consistent with another European study [17]. With the reduction in smoking prevalence and policies to restrict smoking in public places ETS exposure has been decreasing both in Europe and in the United States [17,25].…”

“…In the present study, the prevalence of subjects exposed to ETS in 2012 was 5%, which is consistent with another European study [17]. With the reduction in smoking prevalence and policies to restrict smoking in public places ETS exposure has been decreasing both in Europe and in the United States [17,25]. In Finland, the first law to restrict smoking was put into operation in 1977 [26], and since the 1980s' ETS exposure has decreased significantly [5].…”

“…The decrease in smoking prevalence has also led to a reduction in ETS [5,12]. In altogether 26 European centers, the prevalence of individuals exposed to ETS decreased from 38.7% in 1990-1994 to 7.1% in 2008-2011 [17]. ETS exposure has also been associated with increased mortality [18].…”

The need for clean air: The way air pollution and climate change affect allergic rhinitis and asthma

“…29 Similarly, a recent study from the ECRHS found associations between SHS exposure and physician-diagnosed asthma and poorer asthma control in adults, yet no effect was observed on the lung function. 30…”

How Do Combustion and Non-Combustion Products Used Outdoors Affect Outdoor and Indoor Particulate Matter Levels? A Field Evaluation Near the Entrance of an Italian University Library

“…This is the combination of two phenomena: Second-Hand Smoke (SHS) and Third-Hand Smoke (THS) [6]. ETS is an issue of great public health concern because it has been linked with a large number of pathologies, including cardiovascular, respiratory and neoplastic ones [7][8][9]. In addition to the worsening of indoor air quality, scientific evidence demonstrated that smoking may also be considered a source of outdoor pollution, since it produces pollutants which can contaminate outdoor air and persist for a long time [10][11][12].…”