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Effects of parental smoking on the respiratory health of adults
  1. M N Upton
  1. Correspondence to:
    M N Upton
    Woodlands Family Medical Centre, 106 Yarm Lane, Stockton-on-Tees, Cleveland TS18 1YE, UK; marknuptonaol.com

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Further evidence that parental smoking may have long term effects into adulthood on the respiratory health of offspring

A paper on passive smoking by Cook and Strachan1 published in a Thorax review series in 1999 reported odds ratios (OR) for childhood lower respiratory tract illnesses, respiratory symptoms, and middle ear disease of 1.2–1.6 for either parent smoking, the risks usually being higher in pre-school children than in children of school age. The review concluded that parental smoking was causally associated with impaired lung function in children, but found inconsistent evidence linking parental smoking to allergic sensitisation and suggested that evidence linking maternal smoking to bronchial hyperresponsiveness (BHR) may have arisen from publication bias.1

There is little information from follow up studies about the effect on adult health of exposure to parental smoking,2,3 which is understandable given the logistical difficulties of following individuals for many decades from birth. In this issue of Thorax Svanes and colleagues take a short cut and report cross-sectional results from the European Community Respiratory Health Survey (ECRHS) linking recalled information about parental smoking to respiratory symptoms, asthma, forced expiratory volumes, and BHR in up to 18 688 adults aged 20–44 years from 37 centres in 17 countries.4

For men and women overall, maternal smoking was positively associated with wheeze (OR 1.12), with a composite variable of three or more asthma symptoms (OR 1.14), but not with current asthma. Because of the large sample, 95% confidence intervals were narrow and excluded unity despite excess risks of wheeze and asthma symptoms being low. The possibility that such weak effects may be due to confounding should be considered, although similar sized effects were found in never smokers. Maternal smoking was associated with a forced expiratory volume in 1 second (FEV1) 24 ml lower …

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