University of Oulu

Jaakkola JJK, Hernberg S, Lajunen TK, et al., Smoking and lung function among adults with newly onset asthma, BMJ Open Respiratory Research 2019;6:e000377. doi: 10.1136/bmjresp-2018-000377

Smoking and lung function among adults with newly onset asthma

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Author: Jaakkola, Jouni J K1,2; Hernberg, Samu1,2; Lajunen, Taina K1,2;
Organizations: 1Center for Environmental and Respiratory Health Research, University of Oulu, Oulu, Finland
2Medical Research Center Oulu, Oulu, Finland, Oulu University Hospital
3Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland
4Skin and Allergy Hospital, Helsinki University Hospital and Helsinki University, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.3 MB)
Persistent link:
Language: English
Published: BMJ, 2019
Publish Date: 2019-06-18


Introduction: Smoking increases the risk of asthma and reduces lung function among subjects with and without asthma. We assessed the effects of smoking on lung function reflecting both central and small airways among adults with newly onset asthma.

Methods: In a population-based study, 521 (response rate 86%) working-aged adults with clinically defined newly diagnosed asthma answered a questionnaire on personal smoking and other factors potentially influencing lung function, and performed spirometry. We applied multiple linear regression analysis to estimate the relations between smoking and lung function adjusting for confounding.

Results: Among asthmatics, FEV1 level was reduced significantly, on average 208 mL, related to regular smoking (adjusted effect estimate −0.208, 95% CI −0.355 to −0.061) and 245 mL in relation to former smoking, that is, among those who quit less than a year ago (−0.245, 95% CI −0.485 to −0.004). In contrast, FEV1 was not significantly related to occasional smoking or former smoking among those who quit over a year ago. Forced expiratory flow (FEF) levels (L/s) were also significantly reduced among regular smokers (FEF25–75%: −0.372, 95% CI −0.607 to −0.137; FEF50%: −0.476, 95% CI −0.750 to −0.202). An exposure–response pattern related to both daily smoking rate and lifetime cumulative smoking was seen both among men and women.

Conclusions: This study provides new evidence that among working-aged adults with new asthma, regular smoking and former smoking reduce lung function levels with a dose–response pattern. The lung function parameters applied as outcomes reflect both larger and smaller airways.

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Series: BMJ open respiratory research
ISSN: 2052-4439
ISSN-E: 2052-4439
ISSN-L: 2052-4439
Volume: 6
Issue: 1
Article number: 000377
DOI: 10.1136/bmjresp-2018-000377
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: This study was funded by the Academy of Finland (grants no. 138691 and no. 266314, and grant no. 129419 of SALVE research programme), the Ministry of Social Affairs and Health of Finland (grant no. STM/1523/2012), the Finnish Anti-Tuberculosis Association, Väinö and Laina Kivi Foundation, and Oulu University Hospital Research Fund.
Academy of Finland Grant Number: 138691
Detailed Information: 138691 (Academy of Finland Funding decision)
266314 (Academy of Finland Funding decision)
129419 (Academy of Finland Funding decision)
Copyright information: This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: 4.0/.