Deprivation, smoking, and quality of life in asthma.
OBJECTIVE
To explore associations of deprivation and smoking, with prevalence of asthma, wheeze, and quality of life.


METHODS
Survey, using International Study of Asthma and Allergies in Childhood (ISAAC) methodology, of children aged 13-14 years attending Scottish schools previously surveyed in 1995.


RESULTS
4665/5247 (89%) pupils completed questionnaires. 3656/4665 (78.4%) had missed school for any reason in the last 12 months, 587 (12.6%) because of asthma or wheeze. Compared to children with 1-3 wheeze attacks per year, those with >12 attacks in the last year were more likely to have missed school, twice as likely to have missed physical education in the last month, to report interference with home activities, or to have visited accident and emergency departments, and three times more likely to have been hospitalised. Deprivation was not independently associated with self-reported asthma or wheeze, but was associated with school absence, either for any reason or specifically for asthma or wheeze, but not with use of services such as accident and emergency visits, doctor visits, or hospital admissions. Active smoking was associated with wheezy symptoms, and active and passive smoking with use of medical services. These associations were independent of wheeze severity, treatment taken, and other associated atopic conditions. Smoking also had an impact on school absence and home and school activities.


CONCLUSIONS
Deprivation does not affect the prevalence of asthma or wheeze. Exposure to cigarette smoke was associated with the increased use of services. Deprivation and smoking have independent adverse effects on the quality of life in subjects with asthma or wheeze.
Austin
J B
JB
Department of Child Health, Raigmore Hospital, Inverness IV2 3UJ, Scotland, UK. jane.austin@hpct.scot.nhs.uk
Selvaraj
S
S
Godden
D
D
Russell
G
G
D000041:Absenteeism; D000293:Adolescent; D001249:Asthma / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D011203:Poverty / Q000706:statistics & numerical data*; D015995:Prevalence; D011788:Quality of Life; D012044:Regression Analysis; D012135:Respiratory Sounds / Q000209:etiology; D012606:Scotland / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology
Arch Dis Child. 2000 Jun;82 Suppl 2:II2-5
10833469
Thorax. 1999 Jun;54(6):476-81
10334999
Arch Pediatr Adolesc Med. 2000 Sep;154(9):923-8
10980797
Br J Gen Pract. 2001 Jun;51(467):486-91
11407056
Eur Respir J. 2001 May;17(5):881-6
11488320
J Asthma. 2002 Apr;39(2):107-17
11990227
Respir Med. 2002 Oct;96(10):796-804
12412979
Arch Dis Child. 2004 Mar;89(3):282-5
14977715
Scott Med J. 2004 Feb;49(1):18-21
15012047
BMJ. 2004 May 1;328(7447):1052-3
15028634
Arch Dis Child. 1973 Jun;48(6):467-71
4712777
Arch Dis Child. 1983 Oct;58(10):777-84
6639124
Am J Dis Child. 1990 Nov;144(11):1189-94
2239856
Arch Dis Child. 1994 Mar;70(3):174-8
8135558
Pediatrics. 1994 Jun;93(6 Pt 1):896-902
8190573
Arch Dis Child. 1994 Sep;71(3):211-6
7979493
Am J Respir Crit Care Med. 1995 Aug;152(2):570-5
7633709
BMJ. 1996 Jan 6;312(7022):34
8555858
Thorax. 1996 Jan;51 Suppl 1:S13-7
8658384
Int J Epidemiol. 1996 Jun;25(3):609-16
8671563
Health Bull (Edinb). 1996 Jul;54(4):307-13
8783484
Int J Epidemiol. 1996 Apr;25(2):388-93
9119565
Soc Sci Med. 1997 Mar;44(6):833-58
9080566
Ciba Found Symp. 1997;206:122-34; discussion 134-9, 157-9
9257009
BMJ. 1998 Jan 10;316(7125):118-24
9462318
Respir Med. 1997 Nov;91(10):603-8
9488893
Can Respir J. 2000 Mar-Apr;7(2):163-6
10859402