title: Obesity, low levels of physical activity and smoking present opportunities for primary care asthma interventions: an analysis of baseline data from The Asthma Tools Study.
abstract: BACKGROUND
  Asthma prevalence, severity and outcomes are associated with various patient characteristics and lifestyle choices.
  
  
  OBJECTIVE
  To identify potentially modifiable factors associated with poor asthma outcomes among US primary care patients.
  
  
  METHODS
  Using baseline data from the Asthma Tools Study, we calculated cross-sectional frequencies of activity levels, smoking, secondhand smoke exposure and the presence of obesity, as well as rates of out-of-control asthma and asthma exacerbations. Frequencies were stratified by sex, and into three age groups: 5-11 years, 12-18 years and 19 years and older. Logistic regression was used to identify factors associated with each of the asthma outcomes.
  
  
  RESULTS
  In the 901 individuals enrolled in this asthma study, tobacco smoke exposure, obesity, low activity levels, poverty, inadequately controlled asthma and high asthma-related health-care utilisation were common. Across all age groups, obesity was associated with poorer asthma outcomes: either poor asthma control (odds ratio (OR)=2.3, 95% confidence interval (CI) 1.1-4.7 in 5- to 11-year-olds and OR=1.5, 95% CI 1.1-2.2 in adults) or asthma exacerbations (OR 2.9, 95% CI 1.6-5.1 in 12- to 18-year-olds and OR 1.7, 95% CI 1.1-2.5 in adults). Among adults, smoking was associated with both measures of poorer asthma outcomes; inadequate asthma control (OR=2.3, 95% CI 1.5-3.5), and asthma exacerbations (OR 1.7, 95% CI 1.1-2.6), and low physical activity were associated with poor asthma control (OR=1.5, 95% CI 1.1-2.2).
  
  
  CONCLUSIONS
  Obesity, low levels of physical activity and smoking are common, and they are associated with poor asthma outcomes in a sample of primary care patients, suggesting important targets for intervention.
authors.affiliation: Department of Research, Olmsted Medical Center, Rochester, MN, USA.
authors.forename: Barbara P
authors.initials: BP
authors.lastname: Yawn
authors.affiliation: Division of Allergy, Asthma and Clinical Immunology, Mayo Clinic, Scottsdale, AZ, USA.
authors.forename: Matthew A
authors.initials: MA
authors.lastname: Rank
authors.affiliation: Department of Research, Olmsted Medical Center, Rochester, MN, USA.
authors.forename: Susan L
authors.initials: SL
authors.lastname: Bertram
authors.affiliation: Department of Research, Olmsted Medical Center, Rochester, MN, USA.
authors.forename: Peter C
authors.initials: PC
authors.lastname: Wollan
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009043:Motor Activity; D009765:Obesity / Q000453:epidemiology* / Q000628:therapy; D016017:Odds Ratio; D011320:Primary Health Care; D057185:Sedentary Behavior; D012907:Smoking / Q000453:epidemiology* / Q000628:therapy; D014028:Tobacco Smoke Pollution / Q000517:prevention & control / Q000706:statistics & numerical data*; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution