Odds for respiratory symptoms in 20s high with smoking before adulthood
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Key takeaways:
- Smoking before age 18 years was reported by 70% of 28-year-old ever smokers.
- In addition to smoking before age 18 years, the odds for respiratory symptoms in adulthood rose with pack-years vs. never smoking.
Adults aged 28 years faced heightened odds for respiratory symptoms if they began smoking before turning 18 years old, according to a presentation at the European Respiratory Society International Congress.
“Our findings further highlight the importance of smoking prevention,” Linnéa Hedman, PhD, associate professor of epidemiology and public health at Umeå University in Sweden, told Healio. “That includes both encouragement of children and teenagers to remain tobacco and nicotine free, as well as supporting patients of all ages to quit smoking.”
In this study, Hedman and colleagues analyzed yearly questionnaire responses from 3,430 children aged 8 years until they turned 19 years to find out how smoking debut age is linked to respiratory symptoms and asthma at age 28 years (n = 2,291). Researchers also sought to determine the link between smoking pack-years and respiratory symptoms and asthma reported at 28 years.
At all assessed ages, individuals answered questions about asthma and respiratory symptoms (longstanding cough, sputum production, chronic productive cough, recurrent wheeze or any wheeze last 12 months). At age 13 years and onward, the questionnaire also asked about smoking habits.
Within the study population, 22% of individuals had been a daily smoker at least once, according to researchers. When divided by sex, a higher proportion of women vs. men reported daily smoking (25% vs. 19%; P < .001).
The smoking debut age range with the greatest proportion of 28-year-old ever smokers was tied between age 16 to 17 years (35%; mean pack-years, 1.8) and age 18 years or older (35%; mean pack-years, 1.2). The remaining 29% of ever smokers began smoking at age 15 years or younger (mean pack-years, 2.3).
“[A] surprising result was that almost two-thirds had started smoking before 18 years of age, which is the legal age to buy tobacco products in Sweden,” Hedman told Healio. “This implies that we need to involve more actors in the society in order to apply the available tobacco control measures.”
Each smoking age group had higher proportions of individuals reporting a respiratory symptom in the past 12 months and physician-diagnosed asthma when compared with never smokers (27% and 17%, respectively).
Among the adults aged 28 years who started smoking at age 15 years or younger, 46% experienced an assessed respiratory symptom in the past 12 months and 26% had physician-diagnosed asthma. Similarly, 45% of adults who began smoking at age 16 to 17 years experienced a respiratory symptom and 20% had been diagnosed with asthma. In the group of adults who started smoking at age 18 years or older, 40% had a respiratory symptom and 20% had asthma.
Using a logistic regression model that accounted for sex, education level, family history of asthma and smoking exposure in childhood, researchers observed elevated odds for respiratory symptoms in each smoking debut age group vs. never smokers at age 28 years (≤ 15 years, adjusted OR = 1.8; 95% CI, 1.2-2.7; 16 to 17 years, aOR = 1.8; 95% CI, 1.3-2.6; ≥ 18 years, aOR = 1.5; 95% CI, 1.1-2.1).
Additionally, the odds for respiratory symptoms rose with 1 pack-year of smoking vs. never smoking (aOR = 1.1; 95% CI, 1-1.2) in individuals aged 28 years.
There was no link between smoking debut age or pack-years with adjusted odds for physician-diagnosed asthma, according to researchers.
“It has been known for a long time that smoking increases the risk for respiratory symptoms in older adults, but we can show an association with similar strength already after only a few years of daily smoking in younger adults,” Hedman told Healio.
Reference:
- Smoking before the age of 18 increases the risk of developing respiratory symptoms in your 20s. https://www.ersnet.org/news-and-features/news/smoking-before-the-age-of-18-increases-the-risk-of-developing-respiratory-symptoms-in-your-20s/. Published Sept. 10, 2024. Accessed Sept. 10, 2024.