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Expert Rev Respir Med. 2014 Aug;8(4):503-14. doi: 10.1586/17476348.2014.905913. Epub 2014 May 16.

The independent and combined effects of lifetime smoke exposures and asthma as they relate to COPD.

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1
Unit for Allergy and Lung Health, Centre for Epidemiology and Biostatistics, The University of Melbourne, Melbourne 3010, Victoria, Australia.

Abstract

Chronic obstructive pulmonary disease (COPD) is part of a worldwide tobacco-related disease epidemic, and is associated with progressive airflow obstruction and varying degrees of emphysema and/or hyperinflation. Greater focus has been placed recently on the potential for early life factors to influence the development of COPD, based on the premise that delayed lung growth during childhood and adolescence might predispose to lung disease in later life. For most people, the adverse effects on lung function of adult and early childhood factors are additive, which provides no additional incentive for current smokers to quit. However, if there is a (synergistic) interaction between active smoking and asthma, smoking cessation is likely to have a greater lung function benefit for the smoker who is also asthmatic, especially if quitting occurs at an early age. This article critically evaluates the evidence for the independent associations of lifetime asthma, smoking and smoke exposures with airflow obstruction, plus their interaction when multiple factors are present.

KEYWORDS:

COPD; Interaction; active smoking; asthma; lung function; second-hand smoke; tobacco

PMID:
24834459
DOI:
10.1586/17476348.2014.905913
[Indexed for MEDLINE]
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