Effects of cigarette smoking on lung function in adolescent boys and girls
Effects of cigarette smoking on lung function in adolescent boys and girls
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DOI：
10.1056/nejm199609263351304
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发表时间：
1996-09-26
影响因子：
158.5
通讯作者：
Dockery, DW
中科院分区：
文献类型：
--
作者：
Gold, DR;Wang, XB;Dockery, DW
吸烟对青少年肺功能水平和发育的性别特异性影响知之甚少，在美国，71%的吸烟者尝试了他们的第一支香烟。方法我们研究了吸烟对10至18岁的5158名男孩和4902名女孩的肺功能水平和发育速度的影响，结果发现吸烟与1秒用力呼气量与用力肺活量比值（FEV（1）/FVC）和用力呼气流量占FVC的25 - 75%（FEF（25-75））的降低水平之间存在剂量-反应关系。每天每抽一包烟，女孩的FEF（25-75）减少3.2%（P=0.01），男孩的FEF（25-75）减少3.5%（P=0.007）。吸烟者的FVC水平升高，而FVC和FEV（1）的增长率降低。在同一性别的青少年中，与从不吸烟相比，每天吸烟5支或更多的女孩FEV（1）每年增长慢1.09（95%的置信区间为0.70%至1.47%），男孩的生长速度较慢0.20（95%置信区间，-0.16%至0.56%），女孩（25-75岁）的FEF每年增长缓慢1.25%（95%置信区间，0.38%至2.13%）和0.93%的男孩增长较慢（95%置信区间，0.21%至1.65%）。不吸烟的女孩在17 ~ 18岁时肺功能达到平台期，而吸烟的同龄女孩FEV（1）和FEF（25-75）下降。结论吸烟与青少年轻度气道阻塞和肺功能增长缓慢有关。青少年女孩可能比男孩更容易受到吸烟对肺功能发育的影响。
Background Little is known about the sex-specific effects of cigarette smoking on the level and growth of lung function in adolescence, when 71 percent of people in the United States who smoke tried their first cigarette.Methods We studied the effects of cigarette smoking on the level and rate of growth of pulmonary function in a cohort of 5158 boys and 4902 girls 10 to 18 years of age, examined annually between 1974 and 1989 in six cities in the United States.Results We found a dose-response relation between smoking and lower levels of both the ratio of forced expiratory volume in one second to forced vital capacity (FEV(1)/FVC) and the forced expiratory flow between 25 and 75 percent of FVC (FEF(25-75)). Each pack per day of smoking was associated with a 3.2 percent reduction in FEF(25-75) for girls (P=0.01) and a 3.5 percent reduction in FEF(25-75) for boys (P=0.007). Whereas the FVC level was elevated in smokers, the rate of growth of FVC and FEV(1) was reduced. Among adolescents of the same sex, smoking five or more cigarettes a day, as compared with never smoking, was associated with 1.09 percent slower growth of FEV(1) per year in girls (95 percent confidence interval, 0.70 to 1.47 percent) and 0.20 percent slower growth in boys (95 percent confidence interval, -0.16 to 0.56 percent), and with 1.25 percent slower growth of FEF(25-75) per year in girls (95 percent confidence interval, 0.38 to 2.13 percent) and 0.93 percent slower growth in boys (95 percent confidence interval, 0.21 to 1.65 percent). Whereas girls who did not smoke reached a plateau in lung function at 17 to 18 years of age, girls of the same age who smoked had a decline of FEV(1) and FEF(25-75).Conclusions Cigarette smoking is associated with evidence of mild airway obstruction and slowed growth of lung function in adolescents. Adolescent girls may be more vulnerable than boys to the effects of smoking on the growth of lung function.