European journal of pediatrics, Volume 184, Issue 8, 14 2 2025, Pages 481 ''Unraveling the effects of smoking in asthmatic adolescents: clinical outcomes, spirometry findings, and risk analysis''. Genis C, Tas D, Yılmaz D, Kuzucu FN, Selmanoglu A, Sengul Emeksiz Z, Dibek Mısırlıoglu E
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.
What is known
• Smoking increases asthma severity and reduces treatment response. However, its specific effects on asthma control and lung function in adolescents remain underexplored.
What is new
• This study shows that adolescent smokers have significantly higher rates of uncontrolled asthma, make more frequent visits to the emergency department, and use bronchodilators more often. Smoking, reduced FEV₁%, and atopic status were identified as independent predictors of poor asthma control. These findings highlight the importance of early spirometric evaluation and targeted smoking cessation strategies for adolescents.
