Abstract
Scotland has high rates of death from diseases of the respiratory system and high rates of smoking, especially among women. Data on self reported smoking and prevalence of chronic cough and chronic phlegm among 10,359 men and women aged 40-59 years were obtained from the Scottish Heart Health Study. Overall, current cigarette smokers had rates of chronic cough and chronic phlegm four to five times those of never smokers after standardisation for age (32.3% v 6.5% for men and 24% v 5.5% for women for chronic cough; 31% v 8.3% for men and 21% v 5.5% for women for chronic phlegm). Ex-smokers' symptom rates were a little above those of never smokers and were significant for chronic cough among women and chronic phlegm among men. Men had higher symptom rates than women and this was true for smokers, ex-smokers, and never smokers. The higher rates among men could not be explained by higher cotinine concentrations. Tests to detect "deceivers" among ex-smokers and never smokers using biochemical validation suggested that 87 (1.5%) respondents were in fact smoking; they were excluded from analyses. There were substantially lower rates of chronic cough and chronic phlegm within a year of stopping smoking, and two to four years after stopping 89-99% of the difference between current smokers and never smokers was accounted for (99% and 93% for men and women with chronic cough, 96% and 89% for men and women with chronic phlegm). Even 10 years after stopping, rates of symptoms among ex-smokers remained a little above those of never smokers (except for women with chronic phlegm), though these differences were not statistically significant. Former heavy smokers continued to have rates of chronic cough and chronic phlegm that were higher than those of former light and moderate smokers (though not significantly so). These are cross sectional data, but they emphasise the importance for chronic bronchitis symptoms of giving up cigarette smoking, though the amount previously smoked continues to exert a small influence.
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Selected References
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- Beck G. J., Doyle C. A., Schachter E. N. A longitudinal study of respiratory health in a rural community. Am Rev Respir Dis. 1982 Apr;125(4):375–381. doi: 10.1164/arrd.1982.125.4.375. [DOI] [PubMed] [Google Scholar]
- Comstock G. W., Brownlow W. J., Stone R. W., Sartwell P. E. Cigarette smoking and changes in respiratory findings. Arch Environ Health. 1970 Jul;21(1):50–57. doi: 10.1080/00039896.1970.10667191. [DOI] [PubMed] [Google Scholar]
- Densen P. M., Jones E. W., Bass H. E., Breuer J. A survey of respiratory disease among New York City postal and transit workers. I. Prevalence of symptoms. Environ Res. 1967 Nov;1(3):265–286. doi: 10.1016/0013-9351(67)90018-7. [DOI] [PubMed] [Google Scholar]
- Doll R., Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976 Dec 25;2(6051):1525–1536. doi: 10.1136/bmj.2.6051.1525. [DOI] [PMC free article] [PubMed] [Google Scholar]
- FLETCHER C. M., ELMES P. C., FAIRBAIRN A. S., WOOD C. H. The significance of respiratory symptoms and the diagnosis of chronic bronchitis in a working population. Br Med J. 1959 Aug 29;2(5147):257–266. doi: 10.1136/bmj.2.5147.257. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Feyerabend C., Russell M. A. Rapid gas-liquid chromatographic determination of cotinine in biological fluids. Analyst. 1980 Oct;105(1255):998–1001. doi: 10.1039/an9800500998. [DOI] [PubMed] [Google Scholar]
- Friedman G. D., Siegelaub A. B. Changes after quitting cigarette smoking. Circulation. 1980 Apr;61(4):716–723. doi: 10.1161/01.cir.61.4.716. [DOI] [PubMed] [Google Scholar]
- Gulsvik A. Prevalence of respiratory symptoms in the city of Oslo. Scand J Respir Dis. 1979 Oct;60(5):275–285. [PubMed] [Google Scholar]
- HAMMOND E. C. EVIDENCE ON THE EFFECTS OF GIVING UP CIGARETTE SMOKING. Am J Public Health Nations Health. 1965 May;55:682–691. doi: 10.2105/ajph.55.5.682. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Haenszel W., Hougen A. Prevalence of respiratory symptoms in Norway. J Chronic Dis. 1972 Sep;25(9):519–544. doi: 10.1016/0021-9681(72)90151-8. [DOI] [PubMed] [Google Scholar]
- Higgins M. W., Keller J. B., Metzner H. L. Smoking, socioeconomic status, and chronic respiratory disease. Am Rev Respir Dis. 1977 Sep;116(3):403–410. doi: 10.1164/arrd.1977.116.3.403. [DOI] [PubMed] [Google Scholar]
- Holland W. W., Ashford J. R., Colley J. R., Morgan D. C., Pearson N. J. A comparison of two respiratory symptoms questionnaires. Br J Prev Soc Med. 1966 Apr;20(2):76–96. doi: 10.1136/jech.20.2.76. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Irving J. M., Clark E. C., Crombie I. K., Smith W. C. Evaluation of a portable measure of expired-air carbon monoxide. Prev Med. 1988 Jan;17(1):109–115. doi: 10.1016/0091-7435(88)90076-x. [DOI] [PubMed] [Google Scholar]
- Kiernan K. E., Colley J. R., Douglas J. W., Reid D. D. Chronic cough in young adults in relation to smoking habits, childhood environment and chest illness. Respiration. 1976;33(3):236–244. doi: 10.1159/000193738. [DOI] [PubMed] [Google Scholar]
- Leeder S. R., Colley J. R., Corkhill R., Holland W. W. Change in respiratory symptom prevalence in adults who alter their smoking habits. Am J Epidemiol. 1977 Jun;105(6):522–529. doi: 10.1093/oxfordjournals.aje.a112415. [DOI] [PubMed] [Google Scholar]
- Schenker M. B., Samet J. M., Speizer F. E. Effect of cigarette tar content and smoking habits on respiratory symptoms in women. Am Rev Respir Dis. 1982 Jun;125(6):684–690. doi: 10.1164/arrd.1982.125.6.684. [DOI] [PubMed] [Google Scholar]
- Smith W. C., Crombie I. K., Tavendale R., Irving J. M., Kenicer M. B., Tunstall Pedoe H. The Scottish Heart Health Study: objectives and development of methods. Health Bull (Edinb) 1987 Jul;45(4):211–217. [PubMed] [Google Scholar]
- Smith W. C., Tunstall-Pedoe H., Crombie I. K., Tavendale R. Concomitants of excess coronary deaths--major risk factor and lifestyle findings from 10,359 men and women in the Scottish Heart Health Study. Scott Med J. 1989 Dec;34(6):550–555. doi: 10.1177/003693308903400603. [DOI] [PubMed] [Google Scholar]
- Withey C. H., Price C. E., Swan A. V., Papacosta A. O., Hensley M. J. Repeatability of a questionnaire to assess respiratory symptoms in smokers. J Epidemiol Community Health. 1988 Mar;42(1):54–59. doi: 10.1136/jech.42.1.54. [DOI] [PMC free article] [PubMed] [Google Scholar]