title: Early impact of smoking on lung function, health, and well-being in adolescents.
abstract: BACKGROUND
  Smoking is the single most important risk factor for the development of chronic obstructive pulmonary disease, and more than 80% of adult smokers started smoking before the age of 20. The aim of our study was to evaluate the early impact of smoking on lung function, health, and well-being in adolescents.
  
  
  METHODS
  Twenty-four non-smokers (10 male, 14 female, mean age 17.6 years) and 24 smokers (mean of 3.5 pack-years; 15 male, 9 female, mean age 17.8 years) were compared in terms of lung function, bronchial hyperreactivity (BHR), levels of exhaled carbon monoxide (eCO), exhaled nitric oxide (eNO), and blood counts. A questionnaire containing items from the ISAAC study was used to detect differences in health and well-being.
  
  
  RESULTS
  There were no significant differences in lung function values between non-smokers and smokers (VC 95% vs. 103%, FEV(1) 106% vs. 116%, FEV(1) %/VC MAX 94.6% vs. 95.2%), whereas BHR significantly differed (P < 0.05). Furthermore, significant differences were found for eCO, eNO, Hb, leukocytes, and neutrophils. Health and well-being in terms of sleep and physical activity were significantly worse in smokers.
  
  
  CONCLUSIONS
  Our results suggest an early impact of smoking on health after as few as 3.5 pack-years. Early signs of smoking are an increase in BHR, changes in blood count and a decrease of eNO even before changes in lung function become apparent.
authors.affiliation: Pulmonology, Allergology, and Cystic Fibrosis, Children's Hospital, Goethe University, Frankfurt/Main, Germany. martin.rosewich@kgu.de
authors.forename: Martin
authors.initials: M
authors.lastname: Rosewich
authors.forename: Johannes
authors.initials: J
authors.lastname: Schulze
authors.forename: Olaf
authors.initials: O
authors.lastname: Eickmeier
authors.forename: Susanne
authors.initials: S
authors.lastname: Adler
authors.forename: Markus A
authors.initials: MA
authors.lastname: Rose
authors.forename: Ralf
authors.initials: R
authors.lastname: Schubert
authors.forename: Stefan
authors.initials: S
authors.lastname: Zielen
mesh_terms: D000293:Adolescent; D001772:Blood Cell Count; D001944:Breath Tests; D016535:Bronchial Hyperreactivity / Q000209:etiology* / Q000503:physiopathology; D002248:Carbon Monoxide / Q000032:analysis; D005260:Female; D006304:Health Status; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D009569:Nitric Oxide / Q000032:analysis; D012129:Respiratory Function Tests; D012907:Smoking / Q000009:adverse effects*; D011795:Surveys and Questionnaires
chemical_list: D009569:Nitric Oxide; D002248:Carbon Monoxide