title: Pulmonary effects of active smoking and secondhand smoke exposure among adolescent students in Juárez, Mexico.
abstract: BACKGROUND
  Youth smoking trends among Latin American countries, including Mexico, are on the rise. Notably, although the high prevalence of smoking in teens has been well documented in the literature, few studies have evaluated the impact of smoking and secondhand smoke (SHS) exposure on their respiratory system.
  
  
  OBJECTIVE
  To investigate the effects of smoking and SHS exposure on the respiratory health and lung function among eighth-grade students in Juárez, Mexico.
  
  
  METHODS
  A cross-sectional study was undertaken on a sample of convenience. The study outcomes centered on evaluating 300 students' lung function by spirometry (forced expiratory volume in 1 second [FEV1], forced expiratory volume in 1 second/forced vital capacity ratio [FEV1/FVC], and forced mid-expiratory flow rate [FEF25%-75%]) and their respiratory health (smoking behavior and SHS exposure) by their self-reported responses to a standardized respiratory questionnaire. The study outcomes were compared among three distinct groups: 1) nonsmokers/nonexposed to SHS; 2) nonsmokers/exposed to SHS; and 3) smokers.
  
  
  RESULTS
  The majority of the study participants were 14 years old (85%), females (54%), who attended eighth grade in a public school setting (56%). Approximately, half reported being of low socioeconomic status (49%) and nonsmokers/exposed to SHS (49%). The lung function parameters of smokers were found to be lower (FEV1 =62.88±10.25; FEV1/FVC =83.50±14.15; and FEF25%-75% =66.35±12.55) than those recorded for the nonsmokers/exposed to SHS (FEV1 =69.41±11.35; FEV1/FVC =88.75±15.75; and FEF25%-75% =78.90±14.65) and significantly reduced when compared to the nonsmokers/nonexposed to SHS (FEV1 =79.14±13.61; FEV1/FVC =94.88±21.88; and FEF25%-75% =87.36±17.02) (P<0.001). Similarly, respiratory complaints were more prevalent among smokers and those exposed to SHS when compared to nonsmokers/nonexposed to SHS.
  
  
  CONCLUSIONS
  Our findings suggest that initiation of cigarette smoking and, to a lesser extent, exposure to SHS in adolescence leads to increased respiratory symptoms and reduction of pulmonary function test values. Public health initiatives that aim to prevent smoking initiation, assist in cessation, and lessen SHS exposure of adolescents need to be school-based and employed as early as middle school.
authors.affiliation: School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada.
authors.forename: Yelena
authors.initials: Y
authors.lastname: Bird
authors.affiliation: Institute of Biomedical Sciences, Universidad Autónoma de Ciudad Juárez, Anillo Envolvente del PRONAF y Calle Estocolmo, Ciudad Juárez, Chihuahua, Mexico.
authors.forename: Hugo
authors.initials: H
authors.lastname: Staines-Orozco
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume; D015438:Health Behavior; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008297:Male; D008800:Mexico / Q000453:epidemiology; D015995:Prevalence; D012140:Respiratory Tract Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology; D012959:Socioeconomic Factors; D013147:Spirometry; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D014797:Vital Capacity
chemical_list: D014028:Tobacco Smoke Pollution
keywords: adolescents; lung function; respiratory symptoms; secondhand smoke exposure; smoking