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      Pulmonary effects of active smoking and secondhand smoke exposure among adolescent students in Juárez, Mexico

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          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.


          To investigate the effects of smoking and SHS exposure on the respiratory health and lung function among eighth-grade students in Juárez, Mexico.


          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 [FEV 1], forced expiratory volume in 1 second/forced vital capacity ratio [FEV 1/FVC], and forced mid-expiratory flow rate [FEF 25%–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.


          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 (FEV 1 =62.88±10.25; FEV 1/FVC =83.50±14.15; and FEF 25%–75% =66.35±12.55) than those recorded for the nonsmokers/exposed to SHS (FEV 1 =69.41±11.35; FEV 1/FVC =88.75±15.75; and FEF 25%–75% =78.90±14.65) and significantly reduced when compared to the nonsmokers/nonexposed to SHS (FEV 1 =79.14±13.61; FEV 1/FVC =94.88±21.88; and FEF 25%–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.


          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.

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          Most cited references 45

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            Impact of COPD in North America and Europe in 2000: subjects' perspective of Confronting COPD International Survey.

            To date, no international surveys estimating the burden of chronic obstructive pulmonary disease (COPD) in the general population have been published. The Confronting COPD International Survey aimed to quantify morbidity and burden in COPD subjects in 2000. From a total of 201,921 households screened by random-digit dialling in the USA, Canada, France, Italy, Germany, The Netherlands, Spain and the UK, 3,265 subjects with a diagnosis of COPD, chronic bronchitis or emphysema, or with symptoms of chronic bronchitis, were identified. The mean age of the subjects was 63.3 yrs and 44.2% were female. Subjects with COPD in North America and Europe appear to underestimate their morbidity, as shown by the high proportion of subjects with limitations to their basic daily life activities, frequent work loss (45.3% of COPD subjects of <65 yrs reported work loss in the past year) and frequent use of health services (13.8% of subjects required emergency care in the last year), and may be undertreated. There was a significant disparity between subjects' perception of disease severity and the degree of severity indicated by an objective breathlessness scale. Of those with the most severe breathlessness (too breathless to leave the house), 35.8% described their condition as mild or moderate, as did 60.3% of those with the next most severe degree of breathlessness (breathless after walking a few minutes on level ground). This international survey confirmed the great burden to society and high individual morbidity associated with chronic obstructive pulmonary disease in subjects in North America and Europe.
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                Author and article information

                Int J Chron Obstruct Pulmon Dis
                Int J Chron Obstruct Pulmon Dis
                International Journal of COPD
                International Journal of Chronic Obstructive Pulmonary Disease
                Dove Medical Press
                29 June 2016
                : 11
                : 1459-1467
                [1 ]School of Public Health, University of Saskatchewan, Saskatoon, SK, Canada
                [2 ]Institute of Biomedical Sciences, Universidad Autónoma de Ciudad Juárez, Anillo Envolvente del PRONAF y Calle Estocolmo, Ciudad Juárez, Chihuahua, Mexico
                Author notes
                Correspondence: Yelena Bird, School of Public Health, University of Saskatchewan, 104 Clinic Place, E-Wing Health Sciences, Room 3322, Saskatoon, SK, S7N 2Z4, Canada, Tel +1 306 966 8432, Fax +1 306 966 2264, Email yelena.bird@
                © 2016 Bird and Staines-Orozco. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

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