TY - JOUR T1 - Association of asthma and smoking with lung function impairment in adolescence and early adulthood; the Isle of Wight Birth Cohort Study JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00477-2019 SP - 1900477 AU - S. Hasan Arshad AU - Claire Hodgekiss AU - John W. Holloway AU - Ramesh Kurukulaaratchy AU - Wilfried Karmaus AU - Hongmei Zhang AU - Graham Roberts Y1 - 2019/01/01 UR - http://erj.ersjournals.com/content/early/2019/11/26/13993003.00477-2019.abstract N2 - We investigated associations of asthma and smoking with lung function and airway reversibility from childhood to early adulthood.The population-based Isle of Wight Birth Cohort (n=1456) was assessed at birth, 1, 2, 4, 10, 18 and 26-years. Asthma was defined as physician diagnosis plus current wheeze and/or treatment. Spirometry was conducted at 10 (n=981), 18 (n=839) and 26 years (n=547). Individuals were subdivided into: non-smokers without asthma, non-smokers with asthma, smokers without asthma, and smokers with asthma, based on asthma and smoking status at age 26. Their lung function trajectories from 10 to 26 years were examined using longitudinal models.Non-smokers with asthma had smaller FEV1, FEF25–75 and FEV1/FVC ratio compared to non-smokers without asthma at age 10 and 18, with differences reduced after bronchodilator (pre-bronchodilator FEV1 at 26-years: 3.75 L versus 4.02 L, p<0.001, post-bronchodilator 4.02 L versus 4.16 L, p=0.08). This lung function deficit did not worsen after 18-years. Smokers without asthma had smaller FEF25–75 and FEV1/FVC ratio (but not FEV1) at 26-years compared to non-smokers without asthma with the deficit appearing after 18 years and persisting despite bronchodilator response (for FEV1/FVC ratio at 26-years: 0.80 versus 0.81, p=0.002; post-bronchodilator 0.83 versus 0.85, p=0.005). Smokers with asthma had worst lung function compared to other groups.Lung function deficits associated with asthma and smoking occur early in life. They are not fully responsive to bronchodilator indicating a risk for long term lung health, which highlights the need to institute preventive measures in adolescence and early adult life before irreversible damage occurs.FootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Arshad has nothing to disclose.Conflict of interest: Dr. Hodgekiss has nothing to disclose.Conflict of interest: Dr. Holloway has nothing to disclose.Conflict of interest: Dr. Kurukulaaratchy has nothing to disclose.Conflict of interest: Dr. Karmaus has nothing to disclose.Conflict of interest: Dr. Zhang has nothing to disclose.Conflict of interest: Dr. Roberts has nothing to disclose. ER -