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The Role of Environmental Tobacco Smoke in Asthma Induction and Exacerbation in Children and Adults By Peter N. S. Lee

This book provides a comprehensive and up-to-date review of epidemiological and experimental (chamber) studies relating tobacco smoke (ETS) exposure to the induction and exacerbation of asthma in children and adults. Particular attention is given to separating out the roles of maternal smoking in pregnancy and post-natal ETS exposure on the induction of asthma. It is at a level equivalent to that in peer-reviewed academic publications. Previous reviews by the California EPA and by Strachan and Cook reach different views as to whether ETS exposure induces asthma or not. The book is aimed at clarifying the situation by more detailed and more up-to-date investigations.

CONTENTS

List of Tables vii

List of Figures xi

Supplementary Material xiii

Abbreviations xv

Chapter 1 Objectives 1

Chapter 2 General Approach and Layout of the Book 3

2.1. Introduction 3

2.2. Asthma Exacerbation 3

2.3. Asthma Induction 4

2.4. Overall Conclusions 6

2.5. References 6

2.6. Additional Information 6

Chapter 3 Exacerbation of Asthma – Experimental Evidence 7

3.1. The Studies 7

3.2. Results 23

3.3. Summary and Conclusions 32

3.4. References 34

Chapter 4 Exacerbation of Asthma –Epidemiological Evidence in Adults 39

4.1. The Studies 39

4.2. Results 47

4.3. Summary and Conclusions 52

4.4. References 55

Chapter 5 Exacerbation of Asthma – Epidemiological Evidence in Children 59

5.1. The Studies 59

5.2. Results 102

5.3. Summary and Conclusions 124

5.4. References 130

Chapter 6 Exacerbation of Asthma – Overall Assessment 137

Chapter 7 Induction of Asthma – Methods and General Considerations 139

7.1. Identifying the Studies 139

7.2. Database Structure 140

7.3. Data Entry and Checking 141

7.4. Structure of the Study Database 141

7.5. Study Reports 143

7.6. Problems with Overlapping Studies 143

7.7. Structure of the Relative Risk Database 144

7.8. Identifying which Relative Risks to Enter on the Database 144

7.9. Derivation of the Relative Risks 149

7.10. Carrying out Meta-analyses 151

7.11. References 161

Chapter 8 Induction of Asthma – Evidence in Non-smoking Adults 163

8.1. The Studies 163

8.2. The Relative Risks 172

8.3. The Meta-analyses 179

8.4. Discussion 190

8.5. Summary and Conclusions 197

8.6. References 203

Chapter 9 Induction of Asthma – Evidence in Children 223

9.1. The Studies 223

9.2. The Relative Risks 252

9.3. The Meta-analyses 264

9.4. Discussion 305

9.5. Summary and Conclusions 319

9.6. References 330

Chapter 10 Induction of Asthma – Overall Assessment 433

Final Conclusions 435

Acknowledgements 437

Index 439



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