Abstract

The present study investigated the associations of active, passive, and electronic cigarette (E-cigarette) smoking with asthma in Korean adolescents. We used the cross-sectional study of Korea Youth Risk Behavior Web-based Survey conducted in 2011, 2012 and 2013. Active smoking was classified into 4 groups (0 days, 1–5 days, 6–19 days, and ≥20 days a month). Passive smoking was also categorized into 4 groups (0 days, 1–2 days, 3–4 days, and ≥5 days a week). E-cigarette was defined as yes or no in the last 30 days. Age, sex, obesity, region of residence, economic level, and parental educational level were adjusted for as confounders. Smoking variables were adjusted for one another. Adjusted odd ratios (AORs) and 95% confidence intervals (CIs) were calculated using multiple logistic regression analysis with complex sampling. In total, 2.3% (4,890/216,056) of participants reported asthma in the past 12 months. Active smoking was significantly associated with asthma (AOR [95% CI] of smoking ≥20 days/month = 1.57 [1.38–1.77], P < 0.001). Passive smoking was also related with asthma (AOR [95% CI] of smoking ≥5 days/week = 1.40 [1.28–1.53], P < 0.001). E-cigarette showed positive relation with asthma, although the effects of past smoking history could not be excluded (AOR [95% CI] = 1.12 [1.01–1.26], P = 0.027).

Highlights

  • An estimated 7–10% of adolescents in Korea suffer from asthma, and this prevalence is higher than that of adults (2.0%)[1,2]

  • In addition to former or current tobacco users who transition to E-cigarette, adolescent E-cigarette smokers who have never smoked have increased in prevalence[7]

  • E-cigarette is related to active and passive smoking; approximately 72% of E- cigarette smokers are reported to be past smokers[9]

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Summary

Introduction

An estimated 7–10% of adolescents in Korea suffer from asthma, and this prevalence is higher than that of adults (2.0%)[1,2]. Active smoking continues to increase in adolescents and is currently estimated to affect approximately 14.4% of Korean male adolescents[4]. 46.5% of Korean adolescents are exposed to passive smoking in this rural male adolescent population[5]. In addition to former or current tobacco users who transition to E-cigarette, adolescent E-cigarette smokers who have never smoked have increased in prevalence[7]. The objective of the present study was to investigate the impact of active, passive, and E-cigarette smoking on asthma in Korean adolescents. The present study extends previous studies on the associations of smoking with asthma by using a large representative adolescent population and adjusting for possible confounders including age, sex, physical activity, obesity, region of residence, economic level, parental education levels, and active, passive, and E-cigarette smoking

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