ADULTS who began smoking before the age of 15 have a significantly higher risk of chronic obstructive pulmonary disease (COPD) than those who started later, even when adjusting for smoking history and second-hand smoke exposure, according to a recent study using USA population data.
Researchers analysed data from adults aged 40 and older who participated in Wave 5 (2018–2019) of the Population Assessment of Tobacco and Health Study. Participants who had ever smoked were asked the age at which they started smoking regularly. Multivariable Poisson regression was used to assess the relationship between childhood smoking onset and self-reported COPD diagnosis, adjusting for key factors such as current smoking status, cigarette pack years, smoking duration, second-hand smoke exposure, and sociodemographic variables.
Of the participants, 13.4% reported having COPD. The prevalence of COPD was markedly higher among those who started smoking before age 15 (29.0%) compared to those who started at 15 or later (21.1%) and never-smokers (7.5%). Early smokers also had a greater prevalence of current smoking (45.9% vs. 33.3%), longer smoking duration (mean 34.2 vs. 27.3 years), greater cigarette pack years (mean 48.8 vs. 30.8), and higher second-hand smoke exposure (P<0.05). After adjustment, the relative risk for COPD in those who started smoking before age 15 was 1.27 (95% CI: 1.06–1.51) compared to later starters.
These findings suggest that childhood smoking increases COPD risk beyond what is explained by cumulative smoking exposure alone, highlighting the need for early intervention efforts to prevent youth smoking initiation.
Ada Enesco, EMJ
Reference
Ozga JE et al. Childhood Cigarette Smoking and Risk of COPD in Older United States Adults: A Nationally Representative Replication Study. Chronic Obstr Pulm Dis. 2024;11(6):549-557.
