646: BURDEN OF SUBSTANCE USE AMONG U.S. POPULATION WITH CHILDHOOD AND ADULT-ONSET ASTHMA

Abstract

Introduction: Asthma is the most common chronic childhood disease. Substance use is associated with increasing severity of asthma symptoms and a major risk factor for status asthmaticus or asthma-related death. In the last decade, there is no nationwide literature showing prevalence of various substance use among asthmatics. Aim of this study is to identify the burden of substance use in US population with childhood onset asthma (COA) and adult-onset asthma (AOA) Methods: We conducted a retrospective cross-sectional study using NHANES data from 2013 to 2018. AOA and COA assessed using questionnaire MCQ010 and MCQ025. Drug use variables were summarized and univariate analysis was performed using Mann Whitney test and Chi-square test to determine association between asthma and drug use. Mix-effect multivariate survey logistic regression analysis was performed to identify predictors of AOA and COA. Results: Out of a total of 402,167 participants, prevalence of COA was 10.51% (42,275) and AOA was 4.79% (19,245). Prevalence of methamphetamine use (42.03% vs 41.99% vs 39.34%, p<.0001), was higher in AOA, than COA and no asthma. Smoking (21.41% vs 18.12% vs 16.09%, p<.0001), high alcohol intake (50.98% vs 44.02% vs 47.33%, p<.0001), cocaine use (97.14% vs 93.53% vs 95.30%, p<.0001), marijuana use (62.22% vs 55.42% vs 51.67%, p<.0001) and heroin use (18.89% vs 18.74% vs 14.50%, p<.0001) were more prevalent in COA than AOA and no asthma. In regression analysis, AOA was associated with higher prevalence odds of marijuana use (aOR 2.53, 95%CI 2.53-2.54, p<.0001) and heroin use (1.82, 1.82-1.83, p<.0001) whereas COA was associated with higher prevalence odds of smoking (1.19, 1.19-1.19, p<.0001), alcohol abuse (1.06, 1.06-1.06, p<.0001), cocaine use (67.99, 67.67-68.31, p<.0001) and methamphetamine use (1.67, 1.67-1.67, p<.0001). Conclusions: Substance use is common in childhood and adult asthmatics. Given the high risk of association between asthma and substance use, policy makers and community programs should be built in a way to help improve the compliance in asthma care and decrease rates of substance use disorders in this population. Our study was limited with recall bias, absence of causality, absence of severity and follow up of asthma, and quantification of substance use.