Abstract
Maternal smoking during pregnancy is associated with impaired lung function among young children, but less is known about long-term effects and the impact of adolescents' own smoking. We investigated the influence of maternal smoking during pregnancy, secondhand smoke exposure and adolescent smoking on lung function at age 16 years.The BAMSE (Barn/Child, Allergy, Milieu, Stockholm, Epidemiology) birth cohort collected information on participants' tobacco smoke exposure through repeated questionnaires, and measured saliva cotinine concentrations at age 16 years. Participants performed spirometry and impulse oscillometry (IOS) at age 16 years (n=2295).Exposure to maternal smoking during pregnancy was associated with reduced forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratio of −1.1% (95% CI −2.0 to −0.2%). IOS demonstrated greater resistance at 5–20 Hz (R5–20) in participants exposed to maternal smoking during pregnancy. Adolescents who smoked had reduced FEV1/FVC ratios of −0.9% (95% CI −1.8 to −0.1%) and increased resistance of 6.5 Pa·L–1·s (95% CI 0.7 to 12.2 Pa·L–1·s) in R5–20. Comparable associations for FEV1/FVC ratio were observed for cotinine concentrations, using ≥12 ng·mL−1 as a cut-off for adolescent smoking.Maternal smoking during pregnancy was associated with lower FEV1/FVC ratios and increased airway resistance. In addition, adolescent smoking appears to be associated with reduced FEV1/FVC ratios and increased peripheral airway resistance.
Highlights
Despite continued health campaigns, tobacco smoking remains a pervasive problem and the harmful effects of tobacco smoking and secondhand smoke (SHS) exposure on morbidity and mortality are well established [1, 2]
In this prospective birth cohort, maternal smoking during pregnancy was associated with lower forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC) ratios in the offspring at age 16 years
A tendency of an association between adolescent smoking at age 16 years was associated with lower FEV1/FVC ratios and increased peripheral airway resistance, suggesting early signs of airflow obstruction
Summary
Tobacco smoking remains a pervasive problem and the harmful effects of tobacco smoking and secondhand smoke (SHS) exposure on morbidity and mortality are well established [1, 2]. The prevalence of tobacco smoking among adolescents is declining in high-income countries, the use of some tobacco products such as e-cigarettes has increased and these are often used in conjunction with cigarette smoking [3] Many smokers try their first cigarette in early adolescence and establish habits that can persist into adulthood [4]. Data on the independent effect of adolescent smoking on lung function accounting for maternal smoking during pregnancy are limited, especially utilising prospectively collected data from birth to adolescence [9, 10]. It remains unclear whether interactions between exposure during pregnancy and personal smoking in adolescence exist
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