Variations in the prevalence across countries of chronic bronchitis and smoking habits in young adults

Cerveri, Isa; Accordini, Simone; Verlato, Giuseppe; Corsico, Angelo Guido; Zoia, M. C.; Casali, Lucio; Burney, Peter; Marco, Roberto de

doi:10.1183/09031936.01.00087101

Cited by 123 publications

(91 citation statements)

References 19 publications

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“…In the authors9 previous international study, which focused on subjects of the same age range, the prevalence of airflow obstruction in young adults with chronic cough and phlegm was only 8.4% [33].…”

Section: Discussionmentioning

confidence: 99%

Chronic cough and phlegm in young adults

Cerveri¹,

Accordini²,

Corsico³

et al. 2003

Eur Respir J

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The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines underline that the presence of chronic cough and sputum production before airflow obstruction offers a unique opportunity to identify subjects at risk of chronic obstructive pulmonary disease for an early intervention. Current epidemiological data on these subjects are scant.Between 1998-2000, the authors evaluated the prevalence and characteristics of these symptoms by a multicentre cross-sectional survey of Italian people aged between 20-44 yrs from the general population (Italian Study on Asthma in Young Adults (ISAYA)). Besides the questions on asthma, more than 18,000 subjects answered the question: "Have you had cough and phlegm on most days for as much as 3 months per year and for at least two successive years?"The adjusted prevalence of subjects with chronic cough and phlegm was 11.9%, being 11.8% in males and 12.0% in females. From these subjects y20% reported coexisting asthma and y30%, predominately females, were nonsmokers. The survey showed that sex (female), smoking and low socioeconomic status were significantly and independently associated with chronic cough and phlegm, current smoking playing the major role.The prevalence of subjects with chronic cough and phlegm is startlingly high among young adults. Further follow-up studies are needed to establish how many of them will go on to develop chronic obstructive pulmonary disease. Eur Respir J 2003; 22: 413-417.

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Section: Discussionmentioning

confidence: 99%

Chronic cough and phlegm in young adults

Cerveri¹,

Accordini²,

Corsico³

et al. 2003

Eur Respir J

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“…Table 1 provides an overview of the prevalence of cough and sputum production in population-based studies. CB is seen in 3.4 to 22.0% of adults (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). This wide range of prevalence estimates may be due to varying definitions of CB (i.e., chronic phlegm versus chronic cough and phlegm) as well as the possible inclusion of subjects with bronchiectasis, a syndrome also characterized by chronic cough and daily viscid sputum production that is associated with pathologic airway dilation and recurrent infection.…”

Section: Epidemiologymentioning

confidence: 99%

Chronic Bronchitis and Chronic Obstructive Pulmonary Disease

Kim

Criner

2013

Am J Respir Crit Care Med

387

276

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Chronic bronchitis (CB) is a common but variable phenomenon in chronic obstructive pulmonary disease (COPD). It has numerous clinical consequences, including an accelerated decline in lung function, greater risk of the development of airflow obstruction in smokers, a predisposition to lower respiratory tract infection, higher exacerbation frequency, and worse overall mortality. CB is caused by overproduction and hypersecretion of mucus by goblet cells, which leads to worsening airflow obstruction by luminal obstruction of small airways, epithelial remodeling, and alteration of airway surface tension predisposing to collapse. Despite its clinical sequelae, little is known about the pathophysiology of CB and goblet cell hyperplasia in COPD, and treatment options are limited. In addition, it is becoming increasingly apparent that in the classic COPD spectrum, with emphysema on one end and CB on the other, most patients lie somewhere in the middle. It is known now that many patients with severe emphysema can develop CB, and small airway pathology has been linked to worse clinical outcomes, such as increased mortality and lesser improvement in lung function after lung volume reduction surgery. However, in recent years, a greater understanding of the importance of CB as a phenotype to identify patients with a beneficial response to therapy has been described. Herein we review the epidemiology of CB, the evidence behind its clinical consequences, the current understanding of the pathophysiology of goblet cell hyperplasia in COPD, and current therapies for CB.Keywords: chronic obstructive pulmonary disease; chronic bronchitis; goblet cell hyperplasia; N-acetylcysteine; roflumilast Chronic obstructive pulmonary disease (COPD) is a common disease characterized by irreversible airflow obstruction and persistent inflammation to noxious environmental stimuli, usually cigarette smoke. It affects 12 to 16 million people in the United States and is the third leading cause of death and disease burden worldwide (1). COPD encompasses a spectrum of diseases, with chronic bronchitis (CB) at one end and emphysema at the other, with most individuals having some characteristics of both. The CB definition used in epidemiologic studies has been variable, but the classic definition is chronic cough and sputum production for at least 3 months per year for two consecutive years (2). CB has numerous clinical consequences, including an increased exacerbation rate, accelerated decline in lung function, worse health-related quality of life (HRQoL), and possibly increased mortality (3-6). We review the clinical phenotype of CB, the current understanding of its pathophysiology, and treatment options. EPIDEMIOLOGYCB is common in the general population. Table 1 provides an overview of the prevalence of cough and sputum production in population-based studies. CB is seen in 3.4 to 22.0% of adults (7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19). This wide range of prevalence estimates may be due to varying definitions of CB (i.e., chronic phlegm ver...

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“…In the European Community Respiratory Health Survey (ECRHS) I, which included young adults (aged 20-44 yrs) from 16 countries, 37% were active smokers [5] and 39% of the never-smokers were exposed to passive smoking [6]. The ECRHS I was conducted in 1990-1994 and since then measures to reduce active and passive smoking have been introduced in many countries [7][8][9].…”

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Changes in active and passive smoking in the European Community Respiratory Health Survey

Janson¹

2006

Eur Respir J

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The aim of the present investigation was to study changes and determinants for changes in active and passive smoking.The present study included 9,053 adults from 14 countries that participated in the European Community Respiratory Health Survey II. The mean follow-up period was 8.8 yrs. Change in the prevalence of active and passive smoking was expressed as absolute net change (95% confidence interval) standardised to a 10-yr period. Determinants of change were analysed and the results expressed as adjusted hazard risk ratio (HRR) or odds ratio (OR).The prevalence of active smoking declined by 5.9% (5.1-6.8) and exposure to passive smoking in nonsmokers declined by 18.4% (16.8-20.0). Subjects with a lower educational level (HRR: 0.73 (0.54-0.98) and subjects living with a smoker (HRR: 0.45 (0.34-0.59)) or with workplace smoking (HRR: 0.69 (0.50-0.95)) were less likely to quit. Low socio-economic groups were more likely to become exposed (OR: 2.21 (1.61-3.03)) and less likely to cease being exposed to passive smoking (OR: 0.48 (0.37-0.61)).In conclusion, the quitting rate was lower and the risk of exposure to passive smoking higher among subjects with lower socio-economic status. Exposure to other peoples smoking decreased quitting rates and increased the risk of starting to smoke.

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Variations in the prevalence across countries of chronic bronchitis and smoking habits in young adults

Cited by 123 publications

References 19 publications

Chronic cough and phlegm in young adults

Chronic cough and phlegm in young adults

Chronic Bronchitis and Chronic Obstructive Pulmonary Disease

Changes in active and passive smoking in the European Community Respiratory Health Survey

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