ERICA: smoking is associated with more severe asthma in Brazilian adolescents

Jordão, Erica Azevedo de Oliveira Costa; Kuschnir, Fabio Chigres; Figueiredo, Valeska Carvalho; Félix, Mara Morelo Rocha; Silva, Thiago Luiz Nogueira da; Kuschnir, Maria Cristina Caetano; Bloch, Katia Vergetti; Szklo, Moyses

doi:10.1016/j.jped.2018.05.010

Acessibilidade / Reportar erro

Brasil

Español English

sumário « anterior atual seguinte »

Sumário

Original articles • J. Pediatr. (Rio J.) 95 (5) • Sep-Oct 2019 • https://doi.org/10.1016/j.jped.2018.05.010 copy

ERICA: smoking is associated with more severe asthma in Brazilian adolescents^☆ ☆ Please cite this article as: Jordão EA, Kuschnir FC, Figueiredo VC, Félix MM, Silva TL, Kuschnir MC, et al. ERICA: smoking is associated with more severe asthma in Brazilian adolescents. J Pediatr (Rio J). 2019;95:538-44.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To investigate the association between smoking and asthma, and possible associated factors in Brazilian adolescents.

Methods:

A cross-sectional, national, school-based study with adolescents aged 12-17 years, participants in the Study of Cardiovascular Risks in Adolescents (Estudo de Riscos Cardiovasculares em Adolescentes - ERICA). A total of 66,394 participants answered a self-administered questionnaire with questions about asthma, smoking, lifestyle and sociodemographic variables. Bivariate analysis between Current Asthma (CA) and Severe Asthma (SA) and the other study variables were performed using Chi-squared. Then, the crude and adjusted Prevalence Ratios (PR), and respective 95% Confidence Intervals (95% CI) of current asthma/severe asthma and smoking variables, corrected for sociodemographic and lifestyle variables, were estimated using generalized linear models with Poisson regression, logit link, and robust variance.

Results:

The prevalence of current asthma and severe asthma were significantly higher in adolescents who were exposed to: experimentation (current asthma: PR = 1.78, 95% CI: 1.51-2.09; severe asthma: PR = 2.01; 95% CI: 1.35-2.98); current smoking (current asthma: PR = 2.08, 95% CI: 1.65-2.64; severe asthma: PR = 2.29; 95% CI: 1.38-3.82); regular smoking (current asthma: PR = 2.25, 95% CI: 1.64-3.07; severe asthma: PR: 2.41; 95% CI: 1.23-4.73); and passive smoking (current asthma: PR = 1.47, 95% CI: 1.27-1.67; severe asthma: PR = 1.66; 95% CI: 1.19-2.32); these associations remained significant after adjustment.

Conclusions:

Asthma and smoking were significantly associated in Brazilian adolescents, regardless of the sociodemographic and lifestyle factors, notably in those with more severe disease.

KEYWORDS
Adolescent; Asthma; Epidemiological studies; Smoking

Characteristics	Total (n)	%	No asthma		Current asthma		PR	95% CI
			Total (n)	%	Total (n)	%
Age range							1.05	0.93-1.18^a a p = 0.435.
12-14 y	30,339	45.7	26,716	88.1	3623	11.9
15-17 y	36,055	54.3	30,915	85.7	5140	14.3
Gender							1.34	1.23-1.45^b b p < 0.01.
Male	29,842	45.0	26,664	89.4	3178	10.6
Female	36,552	55.0	30,967	84.7	5585	15.3
Type of school							1.28	1.11-1.47^b b p < 0.01.
Public	52,131	78.5	45,572	87.4	6559	12.6
Private	14,263	21.5	12,059	84.6	2204	15.4
Physical activity							1.08	0.99-1.20^c c p = 0.51. Poisson regression.
Sedentary	30,172	49.1	26,334	87.3	3838	12.7
Active	31,210	50.9	27,013	86.5	4197	13.4
Ethnicity							1.25	1.10-1.43^b b p < 0.01.
Black	38,968	60.2	34,080	87.5	4888	12.5
White/others	25,751	39.8	22,025	85.5	3726	14.5

Variables	Current asthma		Severe asthma
	_CrudePR 95% CI	_AdjustedPR 95% CI	_CrudePR 95% CI	_AdjustedPR 95% CI
Not exposed	1.00	1.00	1.00	1.00
Experimentation	1.78 (1.51-2.09)^a a p < 0.0001.	1.81 (1.57-2.08)^a a p < 0.0001.	2.01 (1.35-2.98)^b b p < 0.01.	2.12 (1.49-300)^a a p < 0.0001.
Current smoking	2.08 (1.65-2.64)^a a p < 0.0001.	2.14 (1.66-2.75)^a a p < 0.0001.	2.29 (1.38-3.82)^b b p < 0.01.	2.45 (1.38-3.82)^a a p < 0.0001.
Regular smoking	2.25 (1.64-3.07)^a a p < 0.0001.	2.33 (1.69-3.20)^a a p < 0.0001.	2.41 (1.23-4.73)^c c p = 0.011. Poisson regression.	2.49 (1.29-4.80)^b b p < 0.01.
Passive smoking	1.47 (1.27-1.67)^a a p < 0.0001.	1.50 (1.29-1.76)^a a p < 0.0001.	1.66 (1.19-2.32)^b b p < 0.01.	1.73 (1.24-2.41)^b b p < 0.01.

Sociedade Brasileira de Pediatria Av. Carlos Gomes, 328 cj. 304, 90480-000 Porto Alegre RS Brazil, Tel.: +55 51 3328-9520 - Porto Alegre - RS - Brazil
E-mail: jped@jped.com.br

Acompanhe os números deste periódico no seu leitor de RSS

[1] * Corresponding author. E-mail:erica.azevedo@gmail.com (E.A. Jordão).