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

BACKGROUND: Despite extensive knowledge of smoking effects on respiratory disease, there is no study including all age windows of exposure among ever smokers. The objective of this study was to assess the effects from smoking exposure in utero, early childhood, adolescence and adulthood on respiratory health outcomes in adult male and female ever smokers. METHODS: Respiratory health outcomes were assessed in 10,610 participants of the European Community Respiratory Health Survey (ECRHS) I who reported a history of ever smoking by questionnaire. The associations of maternal smoking in utero, maternal smoking during childhood, age of smoking debut and pack-years of smoking with respiratory symptoms, obstructive diseases and bronchial hyperreactivity were analysed using generalized linear regression, non-linearity between age of smoking debut and outcomes were assessed by Generalized additive mixed models. RESULTS: Respiratory symptoms and asthma were more frequent in adults if their mother smoked during pregnancy, and, in men, also if mother smoked in childhood. Wheeze and ≥3 respiratory symptoms declined with later smoking debut among women [≤10 years: OR = 3.51, 95% CI 1.26, 9.73; 11-12 years: 1.57[1.01-2.44]; 13-15 years: 1.11[0.94-1.32] and ≤10 years: 3.74[1.56-8.83]; 11-12 years: 1.76[1.19-2.56]; 13-15 years: 1.12[0.94-1.35], respectively]. Effects of increasing number of packyears were pronounced in women (Chronic Obstructive Pulmonary Disease (COPD): OR/10 packyears women: 1.33 [1.18, 1.50], men: 1.14 [1.04, 1.26] pinteraction = 0.01). CONCLUSIONS: 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.

Asthma in reproductive-aged women with polycystic ovary syndrome and association with obesity.

Recent research suggests that women with polycystic ovary syndrome (PCOS) may have a higher prevalence of asthma. However, there are no epidemiological studies aimed primarily at exploring the relationship between PCOS and asthma, and the effect of body mass index (BMI) on this association.This study is a cross-sectional analyses of data from the Australian Longitudinal Study on Women's Health, a large, community-based, prospective study to examine the association between PCOS and asthma in women aged 28-33 years (n=478 PCOS and n=8134 controls).The prevalence of asthma was 15.2% in women with PCOS and 10.6% in women without PCOS (p=0.004). Women with PCOS who had asthma had a trend for a higher BMI compared with women without asthma (29.9±0.9 versus 27.7±0.4 kg·m-2; p=0.054). Women without PCOS who had asthma had a higher BMI compared with women without asthma (26.4±0.2 versus 24.9±0.1 kg·m-2; p<0.001). After adjusting for age, BMI and smoking status, PCOS was associated with increased odds of asthma (odds ratio 1.34, 95% CI 1.004-1.79; p=0.047).This study showed both PCOS status and overweight/obese status were independently associated with asthma. Further prospective studies are required to explore the possible mechanisms underpinning the association between asthma and PCOS.