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Active Smoking, Secondhand Smoke and Chronic Bronchitis in Taiwanese Women: A Community-Based Study

Wu, C*; Wu, M*†; Chong, ; Wu, K§; Hwang, J; Christiani, D C

doi: 10.1097/01.ede.0000276425.54315.12

*Graduate Institute of Occupational Safety and Health, Kaohsiung Medical University, Kaohsiung, Taiwan; †Graduate Institute of Environmental Health, Taiwan; ‡Division of Pulmonology, Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; §Division of Environmental Health and Occupational Medicine, National Health Research Institutes, Miaoli, Taiwan; and ¶Department of Environmental Health, Harvard School of Public Health, Boston, Massachusetts.


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The prevalence of cigarette smoking, a known risk factor for chronic bronchitis, is minimal among women (3%–4%) in Taiwan, compared with the men (55%–62%). This provides a good opportunity to study relationship between secondhand smoke (SHS) and chronic bronchitis in Taiwanese women.

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Material and Methods:

Using Taiwan's National Health Insurance Bureau claims data, we collected 210 potential cases, who were diagnosed with chronic bronchitis at least twice in 1999, and 210 age- and district-matched potential controls. We cross-checked their diagnosis of chronic bronchitis using criteria set by the American Thoracic Society (ATS). Only study subjects who had lived in Kaohsiung, Taiwan, for a minimum of 5 years were included. Both groups were interviewed and administered pulmonary function tests.

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Thirty-three women had chronic bronchitis, 174 had probable chronic bronchitis, and 204 were free of pulmonary disease. After adjusting for other covariates, women who smoked and women who were exposed to SHS in lifetime were 23.63 times (95% CI: 5.45–102.50) and 3.76 times (95% CI: 1.20–11.76) more likely to develop chronic bronchitis than those not exposed to SHS. The mean FEV1 decrease was 245 mL (P = 0.002) in active smokers and 104 mL (P = 0.010) in those exposed to SHS, compared with those not exposed to SHS. The population-attributable risk percentages (PAR%) for active smoking and SHS for chronic bronchitis were 23.2% and 47.5%.

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Exposure to SHS is a major risk factor for chronic bronchitis among women in Taiwan.

© 2007 Lippincott Williams & Wilkins, Inc.