title: Individual and combined impact of cigarette smoking, anxiety, and mood disorders on asthma control.
abstract: BACKGROUND
  Despite the availability of effective therapies, research indicates that more than 50% of asthmatics are poorly controlled. Poor asthma control has been linked to behavioral (i.e., cigarette smoking) and psychological factors (i.e., anxiety and depression). However, little is known about the individual versus combined impact of cigarette smoking and anxiety or mood disorders in adult asthmatics on asthma control.
  
  
  METHODS
  A total of 796 confirmed adult asthma patients completed a sociodemographic and medical history interview and underwent a psychiatric interview using the Primary Care Evaluation of Mental Disorders. Asthma control was evaluated using the Asthma Control Questionnaire.
  
  
  RESULTS
  After adjusting for age, sex, and dose of inhaled corticosteroids, general linear model analyses indicated a significant main effect of current smoking on asthma control (B [SE] = 0.156 [0.059], p = .008) and main effects of anxiety disorders (B [SE] = 0.408 [0.095], p = < .001) and mood disorders (B [SE] = 0.448 [0.098], p = < .001) on asthma control. Pack-years were not associated with asthma control, and there were no interaction effects of current smoking or pack-years with either anxiety or mood disorders on asthma control.
  
  
  CONCLUSIONS
  Findings suggest that current smoking, having an anxiety disorder, and having a mood disorder are independently associated with poorer asthma control but that cumulative smoking history (i.e., pack-years) was not associated with worse asthma control. These results indicate that smoking cessation may have a positive impact on asthma control levels in spite of past smoking intensity and highlight the importance of interventions that target anxiety and mood disorders in adult asthmatics.
authors.affiliation: Department of Psychology, Montréal Behavioural Medicine Centre, University of Quebec at Montréal, P.O. Box 8888, Succursale Center-Ville, Montréal, Quebec H3C 3P8, Canada.
authors.forename: Karine
authors.initials: K
authors.lastname: Ouellet
authors.forename: Simon L
authors.initials: SL
authors.lastname: Bacon
authors.forename: Maxine
authors.initials: M
authors.lastname: Boudreau
authors.forename: Annik
authors.initials: A
authors.lastname: Plourde
authors.forename: Gregory
authors.initials: G
authors.lastname: Moullec
authors.forename: Kim L
authors.initials: KL
authors.lastname: Lavoie
mesh_terms: D000328:Adult; D000368:Aged; D001008:Anxiety Disorders / Q000453:epidemiology* / Q000523:psychology; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D005260:Female; D006801:Humans; D007406:Interview, Psychological; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000453:epidemiology* / Q000523:psychology; D011788:Quality of Life; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires