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. 2000 Dec;54(12):917–922. doi: 10.1136/jech.54.12.917

Cigarette smoking gives more respiratory symptoms among women than among men The Nord-Trøndelag Health Study (HUNT)

A Langhammer 1, R Johnsen 1, J Holmen 1, A Gulsvik 1, L Bjermer 1
PMCID: PMC1731608  PMID: 11076988

Abstract

STUDY OBJECTIVE—Studies have indicated that women are more vulnerable to the effect of tobacco smoking compared with men. The aim of this study was to explore the prevalence of reported respiratory symptoms and diseases according to smoking burden, age and sex.
DESIGN—Questionnaire in a cross sectional population based study.
SETTING—The BONT (Bronchial obstruction in Nord-Trøndelag) study is part of a comprehensive health survey of all inhabitants aged above 19 years in the county of Nord-Trøndelag, Norway, which was carried out from 1995 to 1997.
PARTICIPANTS—A total of 65 717 subjects, 71.3% of the total population aged 20-100, answered the main questionnaire.
MAIN RESULTS—In all, 12.7% men and 12.1% women reported episodes of wheezing or breathlessness during the past 12 months, 8.8% men and 8.4% women reported that they had or had had asthma, 7.5% men and 8.2% women had ever used asthma medication, and 4.0% men and 3.0% women reported chronic bronchitis. Thirty per cent of men and 31% of women were smokers, and average pack years of smoking were 15.9 and 10.3, respectively. Among previous and current smokers, significant more women reported episodes of wheezing or breathlessness, current asthma and persistent coughing compared with men with the same smoke burden (pack years) and daily number of cigarettes.
CONCLUSION—The prevalence of reported asthma and use of asthma medication was higher than reported in previous Scandinavian studies. Respiratory symptoms increased by smoking burden. Comparing the prevalence of symptoms and current asthma among women and men with the same smoke burden or daily cigarette consumption, women seemed to be more susceptible to the effect of tobacco smoking than men.


Keywords: asthma; chronic bronchitis; coughing; tobacco smoking

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Selected References

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  1. Amos A. Women and smoking. Br Med Bull. 1996 Jan;52(1):74–89. doi: 10.1093/oxfordjournals.bmb.a011534. [DOI] [PubMed] [Google Scholar]
  2. Bakke P., Gulsvik A. Allergiske sykdommer i Norge. Operative definisjoner, forekomst og riskofaktorer. Nord Med. 1992;107(4):108-9, 111. [PubMed] [Google Scholar]
  3. Bakke P., Gulsvik A., Lilleng P., Overå O., Hanoa R., Eide G. E. Postal survey on airborne occupational exposure and respiratory disorders in Norway: causes and consequences of non-response. J Epidemiol Community Health. 1990 Dec;44(4):316–320. doi: 10.1136/jech.44.4.316. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Becklake M. R., Lalloo U. The 'healthy smoker': a phenomenon of health selection? Respiration. 1990;57(3):137–144. doi: 10.1159/000195837. [DOI] [PubMed] [Google Scholar]
  5. Brown C. A., Crombie I. K., Smith W. C., Tunstall-Pedoe H. The impact of quitting smoking on symptoms of chronic bronchitis: results of the Scottish Heart Health Study. Thorax. 1991 Feb;46(2):112–116. doi: 10.1136/thx.46.2.112. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Burney P. G., Luczynska C., Chinn S., Jarvis D. The European Community Respiratory Health Survey. Eur Respir J. 1994 May;7(5):954–960. doi: 10.1183/09031936.94.07050954. [DOI] [PubMed] [Google Scholar]
  7. Camargo C. A., Jr, Weiss S. T., Zhang S., Willett W. C., Speizer F. E. Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. Arch Intern Med. 1999 Nov 22;159(21):2582–2588. doi: 10.1001/archinte.159.21.2582. [DOI] [PubMed] [Google Scholar]
  8. Carpenter L., Beral V., Strachan D., Ebi-Kryston K. L., Inskip H. Respiratory symptoms as predictors of 27 year mortality in a representative sample of British adults. BMJ. 1989 Aug 5;299(6695):357–361. doi: 10.1136/bmj.299.6695.357. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Chen Y., Dales R., Krewski D., Breithaupt K. Increased effects of smoking and obesity on asthma among female Canadians: the National Population Health Survey, 1994-1995. Am J Epidemiol. 1999 Aug 1;150(3):255–262. doi: 10.1093/oxfordjournals.aje.a009996. [DOI] [PubMed] [Google Scholar]
  10. Chinn S., Burney P. G. On measuring repeatability of data from self-administered questionnaires. Int J Epidemiol. 1987 Mar;16(1):121–127. doi: 10.1093/ije/16.1.121. [DOI] [PubMed] [Google Scholar]
  11. Dodge R., Cline M. G., Burrows B. Comparisons of asthma, emphysema, and chronic bronchitis diagnoses in a general population sample. Am Rev Respir Dis. 1986 Jun;133(6):981–986. doi: 10.1164/arrd.1986.133.6.981. [DOI] [PubMed] [Google Scholar]
  12. Flodin U., Jönsson P., Ziegler J., Axelson O. An epidemiologic study of bronchial asthma and smoking. Epidemiology. 1995 Sep;6(5):503–505. doi: 10.1097/00001648-199509000-00007. [DOI] [PubMed] [Google Scholar]
  13. Freund K. M., Belanger A. J., D'Agostino R. B., Kannel W. B. The health risks of smoking. The Framingham Study: 34 years of follow-up. Ann Epidemiol. 1993 Jul;3(4):417–424. doi: 10.1016/1047-2797(93)90070-k. [DOI] [PubMed] [Google Scholar]
  14. Gold D. R., Wang X., Wypij D., Speizer F. E., Ware J. H., Dockery D. W. Effects of cigarette smoking on lung function in adolescent boys and girls. N Engl J Med. 1996 Sep 26;335(13):931–937. doi: 10.1056/NEJM199609263351304. [DOI] [PubMed] [Google Scholar]
  15. Gulsvik A. Prevalence and manifestations of obstructive lung disease in the city of Oslo. Scand J Respir Dis. 1979 Oct;60(5):286–296. [PubMed] [Google Scholar]
  16. Gulsvik A. Prevalence of respiratory symptoms in the city of Oslo. Scand J Respir Dis. 1979 Oct;60(5):275–285. [PubMed] [Google Scholar]
  17. Holmen J., Midthjell K., Forsén L., Skjerve K., Gorseth M., Oseland A. Helseundersøkelsen i Nord-Trøndelag 1984-86. Fremmøtet og sammenlikning av dem som møtte og dem som ikke møtte. Tidsskr Nor Laegeforen. 1990 Jun 10;110(15):1973–1977. [PubMed] [Google Scholar]
  18. Janson C., Chinn S., Jarvis D., Burney P. Physician-diagnosed asthma and drug utilization in the European Community Respiratory Health Survey. Eur Respir J. 1997 Aug;10(8):1795–1802. doi: 10.1183/09031936.97.10081795. [DOI] [PubMed] [Google Scholar]
  19. Key T. J., Pike M. C., Baron J. A., Moore J. W., Wang D. Y., Thomas B. S., Bulbrook R. D. Cigarette smoking and steroid hormones in women. J Steroid Biochem Mol Biol. 1991 Oct;39(4A):529–534. doi: 10.1016/0960-0760(91)90247-3. [DOI] [PubMed] [Google Scholar]
  20. Lundbäck B., Nyström L., Rosenhall L., Stjernberg N. Obstructive lung disease in northern Sweden: respiratory symptoms assessed in a postal survey. Eur Respir J. 1991 Mar;4(3):257–266. [PubMed] [Google Scholar]
  21. Lundbäck B., Stjernberg N., Nyström L., Lundbäck K., Lindström M., Rosenhall L. An interview study to estimate prevalence of asthma and chronic bronchitis. The obstructive lung disease in northern Sweden study. Eur J Epidemiol. 1993 Mar;9(2):123–133. doi: 10.1007/BF00158781. [DOI] [PubMed] [Google Scholar]
  22. Magnus P., Jaakkola J. J. Secular trend in the occurrence of asthma among children and young adults: critical appraisal of repeated cross sectional surveys. BMJ. 1997 Jun 21;314(7097):1795–1799. doi: 10.1136/bmj.314.7097.1795. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Moffatt R. J., Owens S. G. Cessation from cigarette smoking: changes in body weight, body composition, resting metabolism, and energy consumption. Metabolism. 1991 May;40(5):465–470. doi: 10.1016/0026-0495(91)90225-l. [DOI] [PubMed] [Google Scholar]
  24. Montnémery P., Adelroth E., Heuman K., Johannisson A., Johansson S. A., Lindholm L. H., Lundbäck B., Löfdahl C. G. Prevalence of obstructive lung diseases and respiratory symptoms in southern Sweden. Respir Med. 1998 Dec;92(12):1337–1345. doi: 10.1016/s0954-6111(98)90139-1. [DOI] [PubMed] [Google Scholar]
  25. Mossey J. M., Shapiro E. Self-rated health: a predictor of mortality among the elderly. Am J Public Health. 1982 Aug;72(8):800–808. doi: 10.2105/ajph.72.8.800. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Pallasaho P., Lundbäck B., Läspä S. L., Jönsson E., Kotaniemi J., Sovijärvi A. R., Laitinen L. A. Increasing prevalence of asthma but not of chronic bronchitis in Finland? Report from the FinEsS-Helsinki Study. Respir Med. 1999 Nov;93(11):798–809. doi: 10.1016/s0954-6111(99)90265-2. [DOI] [PubMed] [Google Scholar]
  27. Parameswaran K., Hildreth A. J., Chadha D., Keaney N. P., Taylor I. K., Bansal S. K. Asthma in the elderly: underperceived, underdiagnosed and undertreated; a community survey. Respir Med. 1998 Mar;92(3):573–577. doi: 10.1016/s0954-6111(98)90311-0. [DOI] [PubMed] [Google Scholar]
  28. Prescott E., Bjerg A. M., Andersen P. K., Lange P., Vestbo J. Gender difference in smoking effects on lung function and risk of hospitalization for COPD: results from a Danish longitudinal population study. Eur Respir J. 1997 Apr;10(4):822–827. [PubMed] [Google Scholar]
  29. Prescott E., Osler M., Andersen P. K., Hein H. O., Borch-Johnsen K., Lange P., Schnohr P., Vestbo J. Mortality in women and men in relation to smoking. Int J Epidemiol. 1998 Feb;27(1):27–32. doi: 10.1093/ije/27.1.27. [DOI] [PubMed] [Google Scholar]
  30. Rönmark E., Lundbäck B., Jönsson E., Jonsson A. C., Lindström M., Sandström T. Incidence of asthma in adults--report from the Obstructive Lung Disease in Northern Sweden Study. Allergy. 1997 Nov;52(11):1071–1078. doi: 10.1111/j.1398-9995.1997.tb00178.x. [DOI] [PubMed] [Google Scholar]
  31. Vestbo J., Rasmussen F. V. Baseline characteristics are not sufficient indicators of non-response bias follow up studies. J Epidemiol Community Health. 1992 Dec;46(6):617–619. doi: 10.1136/jech.46.6.617. [DOI] [PMC free article] [PubMed] [Google Scholar]
  32. Vesterinen E., Kaprio J., Koskenvuo M. Prospective study of asthma in relation to smoking habits among 14,729 adults. Thorax. 1988 Jul;43(7):534–539. doi: 10.1136/thx.43.7.534. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Waldron I. Patterns and causes of gender differences in smoking. Soc Sci Med. 1991;32(9):989–1005. doi: 10.1016/0277-9536(91)90157-8. [DOI] [PubMed] [Google Scholar]
  34. Weiner P., Magadle R., Waizman J., Weiner M., Rabner M., Zamir D. Characteristics of asthma in the elderly. Eur Respir J. 1998 Sep;12(3):564–568. doi: 10.1183/09031936.98.12030564. [DOI] [PubMed] [Google Scholar]
  35. Williamson D. F., Madans J., Anda R. F., Kleinman J. C., Giovino G. A., Byers T. Smoking cessation and severity of weight gain in a national cohort. N Engl J Med. 1991 Mar 14;324(11):739–745. doi: 10.1056/NEJM199103143241106. [DOI] [PubMed] [Google Scholar]
  36. Xu X., Dockery D. W., Ware J. H., Speizer F. E., Ferris B. G., Jr Effects of cigarette smoking on rate of loss of pulmonary function in adults: a longitudinal assessment. Am Rev Respir Dis. 1992 Nov;146(5 Pt 1):1345–1348. doi: 10.1164/ajrccm/146.5_Pt_1.1345. [DOI] [PubMed] [Google Scholar]
  37. Xu X., Li B., Wang L. Gender difference in smoking effects on adult pulmonary function. Eur Respir J. 1994 Mar;7(3):477–483. doi: 10.1183/09031936.94.07030477. [DOI] [PubMed] [Google Scholar]
  38. Xu X., Weiss S. T., Rijcken B., Schouten J. P. Smoking, changes in smoking habits, and rate of decline in FEV1: new insight into gender differences. Eur Respir J. 1994 Jun;7(6):1056–1061. [PubMed] [Google Scholar]

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