‘’Unraveling the effects of smoking in asthmatic adolescents: clinical outcomes, spirometry findings, and risk analysis’’


Genis C., TAŞ D., Yılmaz D., Kuzucu F. N., Selmanoglu A., Sengul Emeksiz Z., ...More

European Journal of Pediatrics, vol.184, no.8, 2025 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 184 Issue: 8
  • Publication Date: 2025
  • Doi Number: 10.1007/s00431-025-06327-x
  • Journal Name: European Journal of Pediatrics
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, BIOSIS, CAB Abstracts, CINAHL, EMBASE
  • Keywords: Adolescents, Asthma, Asthma control, Smoking, Spirometry
  • Ankara Yıldırım Beyazıt University Affiliated: Yes

Abstract

Adolescent smoking and asthma are major global public health concerns. This study aims to comprehensively assess the impact of smoking on asthma control, pulmonary function, and risk factors for uncontrolled asthma in adolescents. A total of 126 adolescents aged 10 to 18 years were categorized into three groups: (1) smoking asthmatics, (2) non-smoking asthmatics, and (3) smoking non-asthmatics. Asthma symptom control was determined according to the Global Initiative for Asthma (GINA). Demographic and clinical characteristics, pulmonary function test (PFT) results, and healthcare utilization data were compared across the groups. Univariate and multivariate logistic regression analyses were performed to identify risk factors for uncontrolled asthma. Smoking asthmatics exhibited significantly lower FEV₁%, FEF₂₅₋₇₅%, and PEF% values compared to non-smoking asthmatics (p = 0.042, p = 0.045, p = 0.002, respectively). The prevalence of uncontrolled asthma was significantly higher in smoking asthmatics (p = 0.005). Additionally, short-acting bronchodilator use in the past year (p = 0.004) and hospital admissions and/or emergency department visits due to breathlessness (p < 0.001) were significantly increased in this group. In multivariate analysis, current smoking status (OR = 4.973, 95% CI:1.120–22.089, p = 0.035), lower FEV₁% (OR = 1.155, 95% CI:1.077–1.240, p < 0.001), and atopic status (OR = 3.977, 95% CI:1.100–14.382, p = 0.035) emerged as independent predictors of poor asthma control. Conclusion: These findings highlight smoking as a key determinant of worsened pulmonary function, poor asthma control, and increased healthcare utilization among adolescents with asthma. The results underscore the urgent need for smoking cessation strategies in this population, emphasizing their crucial role in preventing long-term pulmonary function decline and improving clinical outcomes. (Table presented.)