Original Article
Effects of Cigarette Smoking on Lung Function in Adolescent Boys and Girls
N Engl J Med 1996; 335:931-937September 26, 1996
- Abstract
Background
Little is known about the sex-specific effects of cigarette smoking on the level and growth of lung function in adolescence, when 71 percent of people in the United States who smoke tried their first cigarette.
Methods
We studied the effects of cigarette smoking on the level and rate of growth of pulmonary function in a cohort of 5158 boys and 4902 girls 10 to 18 years of age, examined annually between 1974 and 1989 in six cities in the United States.
Results
We found a dose–response relation between smoking and lower levels of both the ratio of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) and the forced expiratory flow between 25 and 75 percent of FVC (FEF25–75). Each pack per day of smoking was associated with a 3.2 percent reduction in FEF25–75 for girls (P = 0.01) and a 3.5 percent reduction in FEF25–75 for boys (P = 0.007). Whereas the FVC level was elevated in smokers, the rate of growth of FVC and FEV1 was reduced. Among adolescents of the same sex, smoking five or more cigarettes a day, as compared with never smoking, was associated with 1.09 percent slower growth of FEV1 per year in girls (95 percent confidence interval, 0.70 to 1.47 percent) and 0.20 percent slower growth in boys (95 percent confidence interval, -0.16 to 0.56 percent), and with 1.25 percent slower growth of FEF25–75 per year in girls (95 percent confidence interval, 0.38 to 2.13 percent) and 0.93 percent slower growth in boys (95 percent confidence interval, 0.21 to 1.65 percent). Whereas girls who did not smoke reached a plateau in lung function at 17 to 18 years of age, girls of the same age who smoked had a decline of FEV1 and FEF25–75.
Conclusions
Cigarette smoking is associated with evidence of mild airway obstruction and slowed growth of lung function in adolescents. Adolescent girls may be more vulnerable than boys to the effects of smoking on the growth of lung function. .
Media in This Article
Figure 2
Mean Rates of Pulmonary-Function Growth According to Age, Sex, and Category of Smoking.Figure 1
Sex-Specific Effects of Direct Exposure to Smoke on the Level of Pulmonary Function in Children 10 to 18 Years of Age, Estimated by Regression Analysis.Article Activity
- Article
Among people in the United States who smoked in 1991, 71 percent reported that they tried their first cigarette before the age of 19 years.1 In the 1950s many more boys than girls smoked, but adolescent girls now take up smoking at least as frequently as boys.2 Girls and boys begin smoking at similar ages,1,3 but they may not be at similar stages of physical maturation. Smoking may affect female and male lungs differently, and these sex differences may relate to the caliber of airways or to hormonal status at different stages of life. A higher prevalence of airway hyperresponsiveness in women who smoke than in men who smoke was partly explained by lower airway caliber in women, as measured by the absolute level of forced expiratory volume in one second (FEV1).4 Exposure to cigarette smoke led to a greater increase in the number of mucus-producing tracheal goblet cells in female rats than in male rats; differences between the sexes were related to the estrous cycle.5-7 We examined the sex-specific effects of smoking on the level and growth of lung function in children 10 to 18 years of age. We previously reported the associations between smoking and chest illness, chronic cough, acute bronchitis, and wheezing in these children.8
Methods
A total of 12,253 white children in the first through fourth grades were enrolled from schools in six areas of the United States (Watertown, Massachusetts; Kingston and Harriman, Tennessee; Steubenville and Mingo Junction, Ohio; St. Louis; Portage, Wisconsin; and Topeka, Kansas) between 1974 and 1979.9,10 At each annual examination, up to grade nine, parents or guardians completed a questionnaire requesting information about the smoking habits of parents, demographic data, and a history of respiratory illnesses and symptoms for each child and his or her parents. Each child in grades four through eight was asked privately about personal smoking. Starting in grade nine, the questionnaire was completed by the participating children themselves and included questions about personal smoking.
Annually, each child's standing height in stocking feet was measured. Forced expiratory volumes were measured with a water-filled recording spirometer (Survey Spirometer, Warren E. Collins, Braintree, Mass.) while the subjects were sitting without noseclips. Each child performed at least five forced expirations but not more than eight. Forced vital capacity (FVC) and FEV1 were measured for each expiration judged acceptable by the examiner. The mean of the best three efforts was calculated after corrections for body temperature, ambient pressure, and water saturation. The flow between 25 percent and 75 percent of FVC (FEF25–75) was measured from the expiration with the highest value for the sum of the FVC and FEV1.
Definitions
The children's smoking behavior was divided into five categories: never having smoked, having smoked formerly, or currently smoking 1/2 to 4, 5 to 14, or 15 or more cigarettes per day. Maternal smoking status, found previously to predict the level of lung function in this cohort,11 was modeled with the use of an indicator for former smoking and current smoking measured as the number of cigarettes per day. When relations between smoking and lung function were linear, regression models were considered that included the number of cigarettes smoked per day as a continuous variable and former smoking as a categorical variable. The mean education of the parents was categorized as less than, equal to, or greater than 12 years.
Statistical Analysis
The analyses were restricted to the 10,060 children (5158 boys and 4902 girls) 10 to 18 years of age with at least one measurement of FVC (Table 1Table 1
Characteristics of 10,060 Children 10 to 18 Years of Age with at Least One Measurement of Forced Vital Capacity, According to Sex and Smoking Status.). The logarithm of the level of lung function was modeled as a function of log height and age in sex-specific regressions. Because the relation between pulmonary function and height varies according to age during adolescence, regression models for lung-function level and rate of growth for each one-year interval were estimated. Age-specific intercepts and slopes were linked to produce continuous expected values as a function of age and height.12-14 Regression coefficients were estimated with independence-estimating equations, with estimated variances adjusted for the correlation among repeated measurements.15 Descriptive analyses showed that the effects of smoking on pulmonary function were additive on the logarithmic scale — that is, that smoking produced a proportional deficit in pulmonary function. Estimates and confidence intervals for smoking effects were calculated on the logarithmic scale and then expressed as percentage effects by taking the exponential of the estimates (or confidence intervals), subtracting 1, and multiplying the result by 100. All final regression analyses were sex-specific and adjusted for age, log height at each age, residence, parental education, and the smoking status of the mother. To test for the modification of effects between age group (10 to 14 years or 15 to 18 years) or wheezing status and smoking, we incorporated interaction terms in these models, separately according to sex. We assessed P values for differences between the sexes in the effects of smoking by comparing the difference between the estimated smoking effects in boys and girls, divided by the sum of the standard errors of these estimates, with the standard normal distribution. This is equivalent to assessing sex and smoking interactions in a joint analysis of boys and girls, provided that all other covariates also have sex interactions. All P values are two-tailed.
Examining growth requires pairs of pulmonary-function values to express the changes in the level of function between consecutive years. Hence, there were approximately 10 percent fewer observations for analyses of the growth of lung function than for analyses of lung-function level. The categories of medium smoking and heavy smoking were combined because the number of observations of heavy smoking was small, the observed effects of medium and heavy smoking were similar, and no statistically significant differences were found in the magnitude of the associations with the growth of lung function. The effects of smoking on the growth of lung function were examined on both a relative scale (comparing percentage differences) and an absolute scale (measuring in milliliters).
To assess whether differences in stage of maturity contributed to differences between the sexes in smoking effects, we repeated the analyses after each child's age was centered relative to his or her age at peak growth in height (a measure of the timing of the adolescent growth spurt) — that is, it was expressed as the number of years since the year of peak height growth.16 Peak growth in height was determined only for boys who had three measures of one-year changes in height between the ages of 11.75 and 15.25 years, or four measures between the ages of 10.75 and 16.25 years. Girls were required to have three measures of one-year changes between the ages of 9.75 and 13.25 or four between the ages of 8.75 and 14.25.
Peak height-growth velocity was determined for 70 percent of the girls and 62 percent of the boys. Since the peak height-growth velocity occurred earlier for girls (average, 11.4 years) than for boys (average, 13.5 years), smoking data were sparse for the period before peak growth. Sufficient data were available on both boys and girls to permit comparison of smoking effects between the age of peak height growth and six years later.
Results
Children who took up smoking had higher rates of having had asthma (14 percent vs. 10 percent) and of having had wheezing but not asthma (65 percent vs. 50 percent), and they were more likely to have mothers who smoked than were children who never smoked (Table 1). For both boys and girls, the proportion who smoked increased with increasing age (Table 2Table 2
Prevalence of Smoking in 58,460 Observations of 10,060 Children 10 to 18 Years of Age, According to Sex and Age Group.).8 In observations made when the children were 15 to 18 years of age, the prevalence of current smoking was 17 percent in the boys and 19 percent in the girls. The overall mean number of cigarettes smoked was 8.9 (median, 5.7) for the boys and 7.5 (median, 4.3) for the girls. Girls whose level of smoking was medium (5 to 14 cigarettes per day) or heavy (>15 cigarettes per day) smoked fewer cigarettes on average than boys (0.5 and 1.3 fewer cigarettes per day in the medium and heavy categories, respectively). Rates of wheezing increased according to the amount smoked and were higher for girls than for boys at each level of smoking. In an equal proportion of observations of nonsmoking boys and girls, there was current wheezing (25 percent). The proportion of observations of girls as compared with boys that involved wheezing was 45 versus 39 percent for light smoking, 56 versus 47 percent for medium smoking, and 69 versus 57 percent for heavy smoking (P<0.001 for the differences between the sexes).Smoking and Level of Pulmonary Function
A dose–response relation was found between smoking and lower levels of FEV1/FVC and FEF25–75 (Figure 1Figure 1
Sex-Specific Effects of Direct Exposure to Smoke on the Level of Pulmonary Function in Children 10 to 18 Years of Age, Estimated by Regression Analysis.). Smoking 15 cigarettes or more per day, as compared with never smoking, was associated with a reduction in FEF25–75 of 4.0 percent among the boys (95 percent confidence interval, 0.7 to 7.1 percent) and of 3.2 percent among the girls (95 percent confidence interval, 0.4 to 5.8 percent). No differences between the sexes or consistent age interactions were observed in the relation between smoking and the level of pulmonary function. Each pack per day of smoking was associated with a reduction in FEF25–75 of 3.5 percent among the boys (95 percent confidence interval, 1.0 to 5.9 percent) and of 3.2 percent among the girls (95 percent confidence interval, 0.8 to 5.5 percent). Although there was no dose–response relation between the number of cigarettes smoked and the FVC, the FVC was larger in smokers than nonsmokers, suggesting larger lungs in those who took up smoking.The girls reached the maximal level of lung function between the ages of 16 and 18 years, a period when the level of lung function was still increasing in the boys. For the girls who never smoked, the mean FEF25–75 was 3.82 liters per second, 3.80 liters per second, and 3.80 liters per second at the ages of 16, 17, and 18 years, respectively. Lower mean levels of FEF25–75 were observed in the girls who smoked five or more cigarettes per day: 3.62, 3.69, and 3.65 liters per second at the ages of 16, 17, and 18 years, respectively.
Smoking and Growth of Pulmonary Function
Over the age range of 10 to 18 years, girls who smoked five or more cigarettes per day had a rate of growth of FVC that was 0.76 percent slower per year and a rate of growth of FEV1 that was 1.09 percent slower per year than those of girls who never smoked (Table 3Table 3
Sex-Specific Effects of Direct Exposure to Smoke on the Annual Growth Rate of Pulmonary Function in Children 10 to 18 Years of Age, Estimated by Regression Analysis.). For boys, smoking five or more cigarettes per day was not significantly associated with the growth of FVC (estimated effect, 0.03 percent slower growth per year; 95 percent confidence interval, -0.24 to 0.30 percent; P<0.001 for the difference between the sexes) or FEV1 (estimated effect, 0.20 percent slower growth per year; 95 percent confidence interval, -0.16 to 0.56 percent; P = 0.001 for the difference between the sexes). Smoking five or more cigarettes per day was associated with a significantly slower percentage growth in FEF25–75 for both boys and girls. No significant interactions were found between age and smoking in their relations to lung-function growth.Girls, but not boys, were observed at ages when growth in height and pulmonary function was completed. After the ages of 16 to 17, girls smoking five or more cigarettes per day appeared to have a decline in FEF25–75 and FEV1; in girls who did not smoke, pulmonary function stopped growing (i.e., reached a plateau) but did not decline (Figure 2Figure 2
Mean Rates of Pulmonary-Function Growth According to Age, Sex, and Category of Smoking.).Expressing each child's age relative to the age at peak growth in height had little effect on the estimated differences between girls and boys in the effect of smoking on the rate of growth. The estimates of the effects of smoking five or more cigarettes per day on FVC and FEV1 growth were still significantly larger for girls than for boys (P = 0.02 and P = 0.04 for differences between the sexes, respectively). Boys at or beyond their peak height growth who smoked five or more cigarettes per day had 0.23 percent slower growth per year in FVC (95 percent confidence interval, -0.07 to 0.52 percent) and 0.42 percent slower growth per year in FEV1 (95 percent confidence interval, 0.03 to 0.81 percent) than boys who never smoked. Girls at or beyond their peak height growth who smoked five or more cigarettes per day had 0.85 percent slower growth per year in FVC (95 percent confidence interval, 0.42 to 1.26 percent) and 1.12 percent slower growth per year in FEV1 (95 percent confidence interval, 0.60 to 1.63 percent) than girls who never smoked.
In analyses expressing each child's age relative to the age at peak growth in height, smoking was also associated with a greater absolute deficit in the growth of FVC and FEV1 for girls than for boys, despite the fact that boys in adolescence had significantly higher values for FVC (suggesting larger lung volumes) and FEV1 (suggesting larger airways) than girls.17 For FVC, smoking five or more cigarettes per day, as compared with never smoking, was associated with growth that was 25 ml per year slower in girls (95 percent confidence interval, 10 to 39); the estimated effect in boys was not significant (growth was 1 ml per year slower; 95 percent confidence interval, -13 to 15; P = 0.03 for the difference between the sexes). For FEV1, smoking five or more cigarettes per day was associated with growth of lung function that was 31 ml per year slower in girls (95 percent confidence interval, 16 to 46) and 9 ml per year slower in boys (95 percent confidence interval, -6 to 24) (P = 0.05 for the difference between the sexes). As with percentage growth, the effect of smoking in slowing the absolute growth of FEF25–75 in boys and girls was similar (for boys, 48 ml per second per year; 95 percent confidence interval, 14 to 81; for girls, 38 ml per second per year; 95 percent confidence interval, 3 to 80). For all the measures of lung function considered, estimates of the effects of cigarette smoking on absolute growth in lung function were similar in analyses with and without adjustment for peak growth in height.
Excluding children with a history of asthma from the analysis did not significantly alter the sex-specific relations between cigarette smoking and the level or growth of pulmonary function. For girls, but not for boys, there was an interaction between current wheezing and cigarette smoking. Girls who wheezed when they smoked five or more cigarettes per day had a 2.84 percent lower FEV1/FVC ratio (95 percent confidence interval, 2.12 to 3.55) and a 6.69 percent lower FEF25–75 level (95 percent confidence interval, 4.15 to 9.16) than nonsmoking girls without wheezing symptoms, after adjustment for age and height.
Discussion
For adolescent girls and boys, we found that relatively small amounts of cigarette smoke cause similar deficits in levels of both FEV1/FVC and FEF25–75, measures described in many studies as the earliest spirometric indicators of airway obstruction and small-airway disease in adult smokers.18-20 Our findings also suggest that although smoking may slow the growth of lung function in both girls and boys, the deficits may be greater in girls. The effects of smoking on the growth of lung function were greater in girls in absolute as well as percentage terms, despite the fact that boys had larger forced expiratory volumes and reported that they smoked more cigarettes. Tager and colleagues21 demonstrated associations between smoking and both a lower level and slower growth of lung function in both female and male adolescents from East Boston, Massachusetts; the size of the sample limited the study's capacity to examine sex-specific differences. Previous studies of adults from the same six areas of the United States as the children in our study suggested that cigarette smoke had a larger effect on lung function in men; the effect on lung function of smoking one pack of cigarettes per day for a year (one pack-year) was a 0.36 percent annual loss of FEV1 for men and a 0.29 percent annual loss for women.22,23 This sex-specific difference may relate not to heightened sensitivity of men's lungs to cigarette smoke but to a cohort effect, since women had fewer cumulative pack-years of smoke exposure and began smoking at later ages. In a cross-sectional study from Canada, women had greater deficits in lung function per pack-year of cigarettes smoked.24
In our cohort of teenagers, rates of wheezing were higher among girls than boys at each level of smoking. This may relate, in part, to the smaller absolute caliber of the girls' airways, as reflected in their lower absolute levels of FEV1.4,17 Wheezing in response to smoking may not result from the same physiologic mechanisms as wheezing in people with atopic asthma. In analyses adjusted for smoking, premenopausal women were at greater risk for asthma than postmenopausal women, and postmenopausal women receiving hormone therapy were at greater risk than women who were not receiving such therapy.25 Further studies would be needed to assess whether the effect of cigarette smoke on either wheezing symptoms or lung function is modulated by hormonal factors reflected in the stage of the subject's menstrual cycle, the onset of menarche during adolescence, the onset of menopause, or the administration of hormone therapy at other times.
It was not possible to evaluate differences between the sexes in the maximal level of lung function attained or in the effects of smoking on the decline of lung function. Since boys attain their maximal pulmonary function in their early 20s, we were not able to observe the effects of smoking once the growth of pulmonary function ceased. Although our findings suggest that girls who smoke attain a lower maximal level of pulmonary function than nonsmokers and have an earlier decline in pulmonary function, this apparent trend could not be analyzed in girls beyond the age of 18 because of the lack of follow-up data.
There are limitations on the interpretation of analyses comparing the sex-specific effects of cigarette smoking on the growth of lung function in boys and girls in which each child's age is expressed relative to his or her age at peak growth in height. Although we believe that this approach brought us closer to a fair comparison between boys and girls, children at the same stage of peak growth in height are not necessarily at the same stage in other aspects of the onset of puberty. No data were obtained on development of pubertal hair, breast development, or other markers of maturation. Peak growth in height is directly related to peak growth of lung function, and its use as an indicator of the stage of maturation enabled us to exclude fewer observations than if we had centered the children's ages on peak growth of lung function. Nevertheless, a significant proportion of the data could not be used in the comparisons between the sexes that used age at peak growth in height, because of the sparsity of data on smoking for girls before peak height growth and the sparsity of any data for boys more than six years after peak height growth. A decrease in the number of observations by as much as 55 percent in boys and 40 percent in girls may explain the decrease in the magnitude of the significance of sex-specific differences in the analyses centering on peak growth in height as compared with the analyses that included all available data.
The sex-specific differences we observed in the growth of lung function may relate to unmeasured confounders such as sex-specific reporting bias, differences between the sexes in the amount of inhaled smoke per cigarette, or differences in unmeasured exposure to environmental tobacco smoke outside the home. We did not measure cotinine levels to verify the reporting of cigarette smoking. Before taking up smoking, future smokers did not differ from those who had never smoked in their history of illness before the age of two, bronchitis, or chest illness. The age at peak growth in height was similar in these two groups.
Although the growth of FVC was slower among female smokers than nonsmokers, smoking was associated with a higher level of FVC. In the year before they started to smoke, many already had elevated FVC values (data not shown). Other investigators have found that whereas older symptomatic adult smokers with histories of large numbers of pack-years may have lower FVC levels than nonsmokers, young adult smokers have FVC levels equivalent to or higher than age-equivalent nonsmokers.26-29 It is possible that at the time they started smoking, children who had recently developed somewhat larger lungs experienced less discomfort when they experimented with cigarettes and were therefore more inclined to smoke on a regular basis.
In conclusion, the effect of relatively small amounts of cigarette smoke on the level and growth of lung function of children and adolescents is yet another reason to prevent young people from starting to smoke.
Supported in part by a grant (ES-01108) from the National Institute of Environmental Health Sciences, a contract (RP-1001) with the Electric Power Research Institute, and a cooperative agreement (CR11650) with the Health Effects Research Laboratory of the U.S. Environmental Protection Agency. Dr. Gold is an Amalie and Edward Kass Faculty Scholar at the Harvard Medical School.
This paper is dedicated to Professor (Emeritus) Benjamin G. Ferris, Jr., the original principal investigator of the Harvard Six Cities Study, who died August 1, 1996.
Source Information
From the Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School (D.R.G., F.E.S., J.H.W., D.W.D.); and the Environmental Epidemiology Program, Department of Environmental Health (X.W., D.W.D.), and the Department of Biostatistics (D.W., J.H.W.), Harvard School of Public Health — all in Boston.
Address reprint requests to Dr. Gold at the Channing Laboratory, Brigham and Women's Hospital, 180 Longwood Ave., Boston, MA 02115.
- References
References
1
Department of Health and Human Services. Preventing tobacco use among young people: a report of the Surgeon General. Washington, D.C.: Government Printing Office, 1994.
2
Department of Health and Human Services. The health consequences of smoking for women: a report of the Surgeon General. Washington, D.C.: Government Printing Office, 1980.
3
Department of Health and Human Services. Reducing the health consequences of smoking: 25 years of progress: a report of the Surgeon General. Washington, D.C.: Government Printing Office, 1989. (DHHS publication no. (CDC) 89-8411.)
4
Kanner RE ,Connett JE ,Altose MD , et al. Gender differences in airway hyperresponsiveness in smokers with mild COPD: the Lung Health Study. Am J Respir Crit Care Med 1994;150:956-961
Web of Science | Medline5
Hayashi M ,Huber GL . Quantitative differences in goblet cells in the tracheal epithelium of male and female rats. Am Rev Respir Dis 1977;115:595-599
Web of Science | Medline6
Hayashi M ,Sornberger GC ,Huber GL . Differential response in the male and female tracheal epithelium following exposure to tobacco smoke. Chest 1978;73:515-518
CrossRef | Web of Science | Medline7
Chalon J ,Loew DA ,Orkin LR . Tracheobronchial cytologic changes during the menstrual cycle. JAMA 1971;218:1928-1931
CrossRef | Web of Science | Medline8
Gold DR ,Rotnitzky A ,Damokosh AI , et al. Race and gender differences in respiratory illness prevalence and their relationship to environmental exposures in children 7 to 14 years of age. Am Rev Respir Dis 1993;148:10-18
Web of Science | Medline9
Ferris BG Jr ,Speizer FE ,Spengler JD , et al. Effects of sulfur oxides and respirable particles on human health: methodology and demography of populations in study. Am Rev Respir Dis 1979;120:767-779
Web of Science | Medline10
Ware JH ,Dockery DW ,Spiro A III ,Speizer FE ,Ferris BG Jr . Passive smoking, gas cooking, and respiratory health of children living in six cities. Am Rev Respir Dis 1984;129:366-374
Web of Science | Medline11
Wang X ,Wypij D ,Gold DR , et al. A longitudinal study of the effects of parental smoking on pulmonary function in children 6-18 years. Am J Respir Crit Care Med 1994;149:1420-1425
Web of Science | Medline12
Smith PL . Splines as a useful and convenient statistical tool. Am Stat 1979;33:57-62
CrossRef | Web of Science13
Wegman EJ ,Wright IW . Splines in statistics. J Am Stat Assoc 1983;78:351-365
CrossRef | Web of Science14
Wypij D ,Pugh M ,Ware JH . Modeling pulmonary function growth with regression splines. Stat Sinica 1993;3:329-350
Web of Science15
Liang K-Y ,Zeger SL . Longitudinal data analysis using generalized linear models. Biometrika 1986;73:13-22
CrossRef | Web of Science16
Wang X ,Dockery D ,Wypij D , et al. Pulmonary function growth velocity in children 6 to 18 years of age. Am Rev Respir Dis 1993;148:1502-1508
CrossRef | Web of Science | Medline17
Wang X ,Dockery DW ,Wypij D ,Fay ME ,Ferris BG Jr . Pulmonary function between 6 and 18 years of age. Pediatr Pulmonol 1993;15:75-88
CrossRef | Web of Science | Medline18
Macklem PT . Workshop on screening programs for early diagnosis of airway obstruction. Am Rev Respir Dis 1974;109:567-571
Web of Science | Medline19
Wright JL ,Cagle P ,Churg A ,Colby TV ,Myers J . Diseases of the small airways. Am Rev Respir Dis 1992;146:240-262
Web of Science | Medline20
Zamel N ,Altose MD ,Speir WA Jr . Statement on spirometry: a report of the section of respiratory pathophysiology of the American College of Chest Physicians. J Asthma 1983;20:307-311
CrossRef | Web of Science | Medline21
Tager IB ,Munoz A ,Rosner B ,Weiss ST ,Carey V ,Speizer FE . Effect of cigarette smoking on the pulmonary function of children and adolescents. Am Rev Respir Dis 1985;131:752-759
Web of Science | Medline22
Xu X ,Dockery DW ,Ware JH ,Speizer FE ,Ferris BG Jr . Effects of cigarette smoking on rate of loss of pulmonary function in adults: a longitudinal assessment. Am Rev Respir Dis 1992;146:1345-1348
Web of Science | Medline23
Dockery DW ,Speizer FE ,Ferris BG Jr ,Ware JH ,Louis TA ,Spiro A III . Cumulative and reversible effects of lifetime smoking on simple tests of lung function in adults. Am Rev Respir Dis 1988;137:286-292
Web of Science | Medline24
Chen Y ,Horne SL ,Dosman JA . Increased susceptibility to lung dysfunction in female smokers. Am Rev Respir Dis 1991;143:1224-1230
Web of Science | Medline25
Troisi RJ ,Speizer FE ,Willett WC ,Trichopoulos D ,Rosner B . Menopause, postmenopausal estrogen preparations, and the risk of adult-onset asthma: a prospective cohort study. Am J Respir Crit Care Med 1995;152:1183-1188
Web of Science | Medline26
Ferris BG Jr . Epidemiological studies on air pollution and health. Arch Environ Health 1968;16:541-555
Medline27
Walter S ,Nancy NR ,Collier CR . Changes in the forced expiratory spirogram in young male smokers. Am Rev Respir Dis 1979;119:717-724
Web of Science | Medline28
Peters JM ,Ferris BG Jr . Smoking, pulmonary function, and respiratory symptoms in a college-age group. Am Rev Respir Dis 1967;95:774-782
Web of Science | Medline29
Anderson DO ,Ferris BG Jr ,Zickmantel R . The Chilliwack Respiratory Survey, 1963. IV. The effect of tobacco smoking on the prevalence of respiratory disease. Can Med Assoc J 1965;92:1066-1076
Web of Science | Medline
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Anita Shukla, Sareena N. Avadhany, Jean C. Fang, Paula T. Hammond. (2010) Tunable Vancomycin Releasing Surfaces for Biomedical Applications. Small 6:21, 2392-2404
CrossRef21
Mads Nybo, Henrik Steen Hansen, Hans Christian Siersted, Finn Rasmussen. (2010) No relationship between lung function and high-sensitive C-reactive protein in adolescence. The Clinical Respiratory Journal 4:4, 230-236
CrossRef22
Anna Hamari, Tuula Toljamo, Pentti Nieminen, Vuokko L. Kinnula. (2010) High frequency of chronic cough and sputum production with lowered exercise capacity in young smokers. Annals of Medicine 42:7, 512-520
CrossRef23
Fawn Yeh, Everett R. Rhoades, Martha Tarpay, June E. Eichner. (2010) Advantages of Video Questionnaire in Estimating Asthma Prevalence and Risk Factors for School Children: Findings From an Asthma Survey in American Indian Youth. Journal of Asthma 47:7, 711-717
CrossRef24
B. R. Raiff, C. Faix, M. Turturici, J. Dallery. (2010) Breath carbon monoxide output is affected by speed of emptying the lungs: Implications for laboratory and smoking cessation research. Nicotine & Tobacco Research 12:8, 834-838
CrossRef25
R. Lux, B. Borutta, U. Walter. (2010) Passivrauchexposition und Tabakkonsum. Monatsschrift Kinderheilkunde 158:8, 774-782
CrossRef26
Lotte Harmsen, Vibeke Gottlieb, Linda Makowska Rasmussen, Vibeke Backer. (2010) Asthma Patients Who Smoke Have Signs of Chronic Airflow Limitation Before Age 45. Journal of Asthma 47:4, 362-366
CrossRef27
Z. Kabir, G.N. Connolly, H.K. Koh, L. Clancy. (2010) Chronic obstructive pulmonary disease hospitalization rates in Massachusetts: a trend analysis. QJM 103:3, 163-168
CrossRef28
Su-Er Guo, Pamela A Ratner, Joy L Johnson, Chizimuzo TC Okoli, Shahadut Hossain. (2010) Correlates of smoking among adolescents with asthma. Journal of Clinical Nursing 19:5-6, 701-711
CrossRef29
Juan Pablo de Torres Tajes, Ciro Casanova Macario. (2010) EPOC en la mujer. Archivos de Bronconeumología 46, 23-27
CrossRef30
Beverley J. Sheares. 2010. Gender Differences in Pediatric Pulmonary Disease. , 35-50.
CrossRef31
Kavitha Ramchandran, Jyoti D. Patel. (2009) Sex Differences in Susceptibility to Carcinogens. Seminars in Oncology 36:6, 516-523
CrossRef32
Virginia C. Reichert, Vicki Seltzer, Linda S. Efferen, Nina Kohn. (2009) Women and Tobacco Dependence. Obstetrics and Gynecology Clinics of North America 36:4, 877-890
CrossRef33
Juan Pablo de Torres, Ciro Casanova, Claudia G Cote, Bartolome R Celli. (2009) Women with chronic obstructive pulmonary disease: an emerging phenotype of the disease. Therapy 6:6, 821-830
CrossRef34
Jane E. Clougherty. (2009) A Growing Role for Gender Analysis in Air Pollution Epidemiology. Environmental Health Perspectives 118:2, 167-176
CrossRef35
David MG Halpin. (2009) Preventing chronic obstructive pulmonary disease. Expert Review of Respiratory Medicine 3:5, 449-452
CrossRef36
H Aschard, E Bouzigon, E Corda, A Ulgen, M-H Dizier, F Gormand, M Lathrop, F Kauffmann, F Demenais. (2009) Sex-specific effect of IL9 polymorphisms on lung function and polysensitization. Genes and Immunity 10:6, 559-565
CrossRef37
Ilana B. Crome, Marcus R. Munafò. 2009. Epidemiology of Tobacco Use. , 205-232.
CrossRef38
P. Fagan, J. S. Brook, E. Rubenstone, C. Zhang, D. W. Brook. (2009) Longitudinal precursors of young adult light smoking among African Americans and Puerto Ricans. Nicotine & Tobacco Research 11:2, 139-147
CrossRef39
Padmaja Subbarao, Allan Becker, Jeffrey R Brook, Denise Daley, Piush J Mandhane, Gregory E Miller, Stuart E Turvey, Malcolm R Sears. (2009) Epidemiology of asthma: risk factors for development. Expert Review of Clinical Immunology 5:1, 77-95
CrossRef40
Michael A. Chandler, Stephen I. Rennard. 2009. Smoking Cessation. , 599-607.
CrossRef41
Vesna Skodric-Trifunovic, Branislav Gvozdenovic, Dragana Jovanovic, Violeta Vucinic, Dusan Djuric, Miodrag Zunic. (2009) Association between tobacco smoking and pulmonary tuberculosis. Vojnosanitetski pregled 66:10, 797-801
CrossRef42
Sarah E. Wiehe. (2008) Pediatric Office-Based Tobacco Screening and Prevention. Pediatric Annals 37:11, 733-739
CrossRef43
Joshua J. Field, Michael R. DeBaun, Yan Yan, Robert C. Strunk. (2008) Growth of lung function in children with sickle cell anemia. Pediatric Pulmonology 43:11, 1061-1066
CrossRef44
Anurag Mishra, Nagendra K. Kaushik, Akhilesh K. Verma, Rajeev Gupta. (2008) Synthesis, characterization and antibacterial activity of cobalt(III) complexes with pyridine–amide ligands. European Journal of Medicinal Chemistry 43:10, 2189-2196
CrossRef45
Steven B. Pokorny, Sara Corbin, Mark Driscoll, Leonard A. Jason. (2008) The Effect of Enforcement History and Ordinance Provisions on Merchant Compliance With Tobacco-Control Laws. Journal of Social Work Practice in the Addictions 8:2, 228-243
CrossRef46
Margit Pelkonen. (2008) Smoking: relationship to chronic bronchitis, chronic obstructive pulmonary disease and mortality. Current Opinion in Internal Medicine 7:3, 283-287
CrossRef47
Salvatore Cazzato, Venerino Poletti, Filippo Bernardi, Leonardo Loroni, Luca Bertelli, Stefano Colonna, Franco Zappulla, Giuseppe Timoncini, Alessandro Cicognani. (2008) Airway inflammation and lung function decline in childhood post-infectious bronchiolitis obliterans. Pediatric Pulmonology 43:4, 381-390
CrossRef48
Marianne Voll-Aanerud, Tomas M. L. Eagan, Tore Wentzel-Larsen, Amund Gulsvik, Per S. Bakke. (2008) Asthma and health-related quality of life - effect of adjusting for potential confounders. The Clinical Respiratory Journal 2:2, 106-115
CrossRef49
Ira B. Tager. (2008) The effects of second-hand and direct exposure to tobacco smoke on asthma and lung function in adolescence. Paediatric Respiratory Reviews 9:1, 29-38
CrossRef50
Margit Pelkonen. (2008) Smoking: relationship to chronic bronchitis, chronic obstructive pulmonary disease and mortality. Current Opinion in Pulmonary Medicine 14:2, 105-109
CrossRef51
A.J. Henderson. (2008) The effects of tobacco smoke exposure on respiratory health in school-aged children. Paediatric Respiratory Reviews 9:1, 21-28
CrossRef52
Rick Carter, Brian L Tiep, Rebecca E Tiep. (2008) The Emerging Chronic Obstructive Pulmonary Disease Epidemic. Disease Management & Health Outcomes 16:5, 275-284
CrossRef53
G.-H. Dong, Y. Cao, H.-L. Ding, Y.-N. Ma, J. Jin, Y.-D. Zhao, Q.-C. He. (2007) Effects of environmental tobacco smoke on respiratory health of boys and girls from kindergarten: results from 15 districts of northern China. Indoor Air 0:0, 071105095528003-???
CrossRef54
Dennis G Maki, Nasia Safdar, Steven C Ebert. (2007) Prevalence, Consequences, and Solutions. Pharmacotherapy 27:10 Part 2, 121S-125S
CrossRef55
C. Almqvist, M. Worm, B. Leynaert, . (2007) Impact of gender on asthma in childhood and adolescence: a GA 2 LEN review. Allergy 0:0, 070907221144001-???
CrossRef56
Karl A. Franklin, Torbjörn Gustafson, Jonas Ranstam, Kerstin Ström. (2007) Survival and future need of long-term oxygen therapy for chronic obstructive pulmonary disease—gender differences. Respiratory Medicine 101:7, 1506-1511
CrossRef57
Carlos A Jiménez-Ruiz, Juan José Ruiz Martín, Ana Cicero Guerrero, Juan Antonio Riesco Miranda, Jenaro Astray Mochales, Angel Guirao García. (2007) Implementation of Smoking Cessation Services in Respiratory Medicine. The Journal of Smoking Cessation
2:1, 1-4
CrossRef58
Radhika Kajekar. (2007) Environmental factors and developmental outcomes in the lung. Pharmacology & Therapeutics 114:2, 129-145
CrossRef59
Ben J. Smith, Philayrath Phongsavan, Adrian E. Bauman, Drew Havea, Tien Chey. (2007) Comparison of tobacco, alcohol and illegal drug usage among school students in three Pacific Island societies. Drug and Alcohol Dependence 88:1, 9-18
CrossRef60
Linnéa Hedman, Anders Bjerg-Bäcklund, Matthew Perzanowski, Sigrid Sundberg, Eva Rönmark. (2007) Factors related to tobacco use among teenagers. Respiratory Medicine 101:3, 496-502
CrossRef61
Sean B. Pocock, Katherine T. Chen. (2006) Inappropriate Use of Antibiotic Prophylaxis to Prevent Infective Endocarditis in Obstetric Patients. Obstetrics & Gynecology 108:2, 280-285
CrossRef62
Nancy K. Ostrom. (2006) Women with asthma: a review of potential variables and preferred medical management. Annals of Allergy, Asthma & Immunology 96:5, 655-665
CrossRef63
Rakesh Kumar Tiwari, Akhilesh K. Verma, Anil K. Chhillar, Devender Singh, Jaspal Singh, V. Kasi Sankar, Vibha Yadav, G.L. Sharma, Ramesh Chandra. (2006) Synthesis and antifungal activity of substituted-10-methyl-1,2,3,4-tetrahydropyrazino[1,2-a]indoles. Bioorganic & Medicinal Chemistry 14:8, 2747-2752
CrossRef64
Tracy R. Nichols, Amanda S. Birnbaum, Sara Birnel, Gilbert J. Botvin. (2006) Perceived smoking environment and smoking initiation among multi-ethnic urban girls. Journal of Adolescent Health 38:4, 369-375
CrossRef65
Rakesh Kumar Tiwari, Devender Singh, Jaspal Singh, Vibha Yadav, Ajay K. Pathak, Rajesh Dabur, Anil K. Chhillar, Rambir Singh, G.L. Sharma, Ramesh Chandra, Akhilesh K. Verma. (2006) Synthesis and antibacterial activity of substituted 1,2,3,4-tetrahydropyrazino [1,2-a] indoles. Bioorganic & Medicinal Chemistry Letters 16:2, 413-416
CrossRef66
Himanshu Upadhyaya, Deborah Deas, Kathleen Brady, Michael S. Jellinek. (2005) A Practical Clinical Approach to the Treatment of Nicotine Dependence in Adolescents. Journal of the American Academy of Child & Adolescent Psychiatry 44:9, 942-946
CrossRef67
Johanna M. Lewis-Esquerre, Suzanne M. Colby, Tracy O’Leary Tevyaw, Cheryl A. Eaton, Christopher W. Kahler, Peter M. Monti. (2005) Validation of the timeline follow-back in the assessment of adolescent smoking. Drug and Alcohol Dependence 79:1, 33-43
CrossRef68
Karen Glanz, Gertraud Maskarinec, Linda Carlin. (2005) Ethnicity, sense of coherence, and tobacco use among adolescents. Annals of Behavioral Medicine 29:3, 192-199
CrossRef69
John Lynch, George Davey Smith. (2005) A LIFE COURSE APPROACH TO CHRONIC DISEASE EPIDEMIOLOGY. Annual Review of Public Health 26:1, 1-35
CrossRef70
Gary Sutkin, Marijane A. Krohn, R Phillips Heine, Richard L. Sweet. (2005) Antibiotic Prophylaxis and Non–Group B Streptococcal Neonatal Sepsis. Obstetrics & Gynecology 105:3, 581-586
CrossRef71
Teresa Imelda Fortoul, Sandra Moncada-Hernández, Liliana Saldivar-Osorio, Guadalupe Espejel-Maya, Patricia Mussali-Galante, Maria del Carmen Ávila-Casado, Laura Colín-Barenque, Maria Isidra Hernández-Serrato, Maria Rosa Ávila-Costa. (2005) Sex differences in bronchiolar epithelium response after the inhalation of lead acetate (Pb). Toxicology 207:2, 323-330
CrossRef72
Jens Pohlmann, Thomas Lampe, Mitsuyuki Shimada, Peter G. Nell, Josef Pernerstorfer, Niels Svenstrup, Nina A. Brunner, Guido Schiffer, Christoph Freiberg. (2005) Pyrrolidinedione derivatives as antibacterial agents with a novel mode of action. Bioorganic & Medicinal Chemistry Letters 15:4, 1189-1192
CrossRef73
Dennis Nowak, Karin Berger, Barbara Lippert, Katharina Kilgert, Manfred Caeser, Ruediger Sandtmann. (2005) Epidemiology and Health Economics of COPD Across Europe. Treatments in Respiratory Medicine 4:6, 381-395
CrossRef74
Louise Watson, Jorgen Vestbo, Dirkje S Postma, Marc Decramer, Stephen Rennard, Victor A Kiri, Paul A Vermeire, Joan B Soriano. (2004) Gender differences in the management and experience of Chronic Obstructive Pulmonary Disease. Respiratory Medicine 98:12, 1207-1213
CrossRef75
Carlos Torres-Viera, Louise-Marie Dembry. (2004) Approaches to vancomycin-resistant enterococci. Current Opinion in Infectious Diseases 17:6, 541-547
CrossRef76
Suzanne R. Sunday, Patricia Folan. (2004) Smoking in adolescence: what a clinician can do to help. Medical Clinics of North America 88:6, 1495-1515
CrossRef77
Virginia Cullen Reichert, Vicki Seltzer, Linda S. Efferen, Nina Kohn. (2004) Women and tobacco dependence. Medical Clinics of North America 88:6, 1467-1481
CrossRef78
Timothy D. Murphy, Ran D. Anbar, Lucille A. Lester, Samya Z. Nasr, Bruce Nickerson, Donald R. VanDevanter, Andrew A. Colin. (2004) Treatment with tobramycin solution for inhalation reduces hospitalizations in young CF subjects with mild lung disease. Pediatric Pulmonology 38:4, 314-320
CrossRef79
Charles A. Weitz, Ralph M. Garruto. (2004) Growth of Han migrants at high altitude in central Asia. American Journal of Human Biology 16:4, 405-419
CrossRef80
B. Raju, Sampathkumar Anandan, Shihai Gu, Prudencio Herradura, Hardwin O’Dowd, Bum Kim, Marcela Gomez, Corinne Hackbarth, Charlotte Wu, Wen Wang, Zhengyu Yuan, Richard White, Joaquim Trias, Dinesh V. Patel. (2004) Conformationally restricted analogs of deoxynegamycin. Bioorganic & Medicinal Chemistry Letters 14:12, 3103-3107
CrossRef81
Joachim Heinrich, Bernd Hölscher, Margarete Seiwert, Cara L Carty, Günter Merkel, Christine Schulz. (2004) Nicotine and cotinine in adults' urine: The German Environmental Survey 1998. Journal of Exposure Analysis and Environmental Epidemiology
CrossRef82
Javier Ariza, Miquel Pujol. (2004) Nosocomial Antibiotic Resistance in GNB at the ICUs. Clinical Pulmonary Medicine 11:2, 71-83
CrossRef83
Neely Kazerouni, C. J. Alverson, Stephen C. Redd, Joshua A. Mott, David M. Mannino. (2004) Sex Differences in COPD and Lung Cancer Mortality Trends—United States, 1968–1999. Journal of Women's Health 13:1, 17-23
CrossRef84
Kiyoshi Nakayama, Yohei Ishida, Masami Ohtsuka, Haruko Kawato, Ken-ichi Yoshida, Yoshihiro Yokomizo, Shigeru Hosono, Toshiharu Ohta, Kazuki Hoshino, Hiroko Ishida, Kumi Yoshida, Thomas E. Renau, Roger Léger, Jason Z. Zhang, Ving J. Lee, William J. Watkins. (2003) MexAB-OprM-Specific efflux pump inhibitors in Pseudomonas aeruginosa. Part 1: Discovery and early strategies for lead optimization. Bioorganic & Medicinal Chemistry Letters 13:23, 4201-4204
CrossRef85
Diane R. Gold, Andrew I. Damokosh, Douglas W. Dockery, Catherine S. Berkey. (2003) Body-mass index as a predictor of incident asthma in a prospective cohort of children. Pediatric Pulmonology 36:6, 514-521
CrossRef86
Jeremy M. T. Hamilton-Miller. (2003) Chemical and Microbiologic Aspects of Penems, a Distinct Class of β-Lactams: Focus on Faropenem. Pharmacotherapy 23:11, 1497-1507
CrossRef87
Constantine G. Boojamra, Rémy C. Lemoine, Johanne Blais, Nicole G. Vernier, Karin A. Stein, Angela Magon, Suzanne Chamberland, Scott J. Hecker, Ving J. Lee. (2003) Synthetic dihydropacidamycin antibiotics. Bioorganic & Medicinal Chemistry Letters 13:19, 3305-3309
CrossRef88
Ralph M. Garruto, Chen-Ting Chin, Charles A. Weitz, Ji-Chuan Liu, Rui-Ling Liu, Xing He. (2003) Hematological differences during growth among Tibetans and Han Chinese born and raised at high altitude in Qinghai, China. American Journal of Physical Anthropology 122:2, 171-183
CrossRef89
MICHAEL R. JACOBS, CANDICE E. JOHNSON. (2003) Macrolide resistance: an increasing concern for treatment failure in children. The Pediatric Infectious Disease Journal 22:Supplement, S131-S138
CrossRef90
Marin H. Kollef. (2003) Antibiotic heterogeneity: Should we use it? *. Critical Care Medicine 31:7, 2074-2076
CrossRef91
Yue Chen, Robert Dales, Paula Stewart, Helen Johansen, Geoffroy Scott, Gregory Taylor. (2003) Hospital readmissions for asthma in children and young adults in Canada. Pediatric Pulmonology 36:1, 22-26
CrossRef92
John Finn, Karen Mattia, Mike Morytko, Siya Ram, Yingfei Yang, Ximao Wu, Elsa Mak, Paul Gallant, Dennis Keith. (2003) Discovery of a potent and selective series of pyrazole bacterial methionyl-tRNA synthetase inhibitors. Bioorganic & Medicinal Chemistry Letters 13:13, 2231-2234
CrossRef93
ELIO CASTAGNOLA, LUCA BONI, MAREVA GIACCHINO, SIMONE CESARO, LUIGI DE SIO, ALBERTO GARAVENTA, GIULIO A. ZANAZZO, PIERFRANCESCO BIDDAU, MARIO R. ROSSI, FRANCESCO SCHETTINI, PAOLO BRUZZI, CLAUDIO VISCOLI. (2003) A multicenter, randomized, double blind placebo-controlled trial of amoxicillin/clavulanate for the prophylaxis of fever and infection in neutropenic children with cancer. The Pediatric Infectious Disease Journal 22:4, 359-365
CrossRef94
Henry E. Rice, Keith T. Oldham, Cheryl A. Hillery, Michael A. Skinner, Sara M. O’Hara, Russell E. Ware. (2003) Clinical and Hematologic Benefits of Partial Splenectomy for Congenital Hemolytic Anemias in Children. Annals of Surgery 237:2, 281-288
CrossRef95
Christian Frye, Bernd Hoelscher, Josef Cyrys, Matthias Wjst, H.-Erich Wichmann, Joachim Heinrich. (2002) Association of Lung Function with Declining Ambient Air Pollution. Environmental Health Perspectives 111:3, 383-387
CrossRef96
T.L HOLMEN, E BARRETT-CONNOR, J CLAUSEN, A LANGHAMMER, J HOLMEN, L BJERMER. (2002) Gender differences in the impact of adolescent smoking on lung function and respiratory symptoms. The Nord-Trøndelag Health Study, Norway, 1995–1997. Respiratory Medicine 96:10, 796-804
CrossRef97
Douglas Houghton. (2002) Antimicrobial Resistance in the Intensive Care Unit: Understanding the Problem. AACN Clinical Issues: Advanced Practice in Acute and Critical Care 13:3, 410-420
CrossRef98
JOHN S. BRADLEY. (2002) Management of community-acquired pediatric pneumonia in an era of increasing antibiotic resistance and conjugate vaccines. The Pediatric Infectious Disease Journal 21:6, 592-598
CrossRef99
Charles A. Weitz, Ralph M. Garruto, Chen-Ting Chin, Ji-Chuan Liu, Rui-Ling Liu, Xing He. (2002) Lung function of Han Chinese born and raised near sea level and at high altitude in Western China. American Journal of Human Biology 14:4, 494-510
CrossRef100
John K. Wiencke, Karl T. Kelsey. (2002) Teen Smoking, Field Cancerization, and a "Critical Period" Hypothesis for Lung Cancer Susceptibility. Environmental Health Perspectives 110:6, 555-558
CrossRef101
Rémy C. Lemoine, Angela Magon, Scott J. Hecker. (2002) Synthesis of base-modified dihydropacidamycins. Bioorganic & Medicinal Chemistry Letters 12:7, 1121-1123
CrossRef102
Karl Fagerstr??m. (2002) The Epidemiology of Smoking. Drugs 62:Supplement 2, 1-9
CrossRef103
Travis W. Waldrep, Daniel J. Skiest. (2002) Linezolid-Induced Anemia and Thrombocytopenia. Pharmacotherapy 22:1, 109-112
CrossRef104
Miquel Pujol, Francesc Gudiol. (2001) Evidence for antibiotic cycling in control of resistance. Current Opinion in Infectious Diseases 14:6, 711-715
CrossRef105
R. D'IPPOLITO, A. FORESI, A. CHETTA, A. CASTAGNARO, R. MALORGIO, E. MARANGIO, D. OLIVIERI. (2001) Eosinophils in induced sputum from asymptomatic smokers with normal lung function. Respiratory Medicine 95:12, 969-974
CrossRef106
Jill M Siegfried. (2001) Women and lung cancer: does oestrogen play a role?. The Lancet Oncology 2:8, 506-513
CrossRef107
Margot E Kurtz, J.C Kurtz, Shirley M Johnson, Wade Cooper. (2001) Sources of information on the health effects of environmental tobacco smoke among African-American children and adolescents. Journal of Adolescent Health 28:6, 458-464
CrossRef108
Grant W. Waterer, Richard G. Wunderink. (2001) Increasing threat of Gram-negative bacteria. Critical Care Medicine 29:Supplement, N75-N81
CrossRef109
Marin H. Kollef. (2001) Is there a role for antibiotic cycling in the intensive care unit?. Critical Care Medicine 29:Supplement, N135-N142
CrossRef110
Scott K. Fridkin. (2001) Increasing prevalence of antimicrobial resistance in intensive care units. Critical Care Medicine 29:Supplement, N64-N68
CrossRef111
J. T. Magee. (2001) Antibiotic resistance and prescribing in the community. Reviews in Medical Microbiology 12:2, 87-96
CrossRef112
Nino K
CrossRef113
Yue Chen, Krista Breithaupt, Nazeem Muhajarine. (2000) Occurrence of chronic obstructive pulmonary disease among Canadians and sex-related risk factors. Journal of Clinical Epidemiology 53:7, 755-761
CrossRef114
Thomas Zidek, Gerald Haidinger, Angela Zacharasiewicz, Thomas Waldh
CrossRef115
Jack E. Henningfield, Tula Michaelides, Steve Sussman. (2000) Developing Treatment for Tobacco Addicted Youth–Issues and Challenges. Journal of Child & Adolescent Substance Abuse 9:4, 5-26
CrossRef116
Melanie Booth‐Butterfield, Robert Anderson, Kimberly Williams. (2000) Perceived messages from schools regarding adolescent tobacco use. Communication Education 49:2, 196-205
CrossRef117
Kornelis A. Poelstra, Nazir A. Barekzi, David W. Grainger, Anthony G. Gristina, Thomas C. Schuler. (2000) A Novel Spinal Implant Infection Model in Rabbits. Spine 25:4, 406-410
CrossRef118
Michael N Alekshun, Stuart B Levy. (1999) The mar regulon: multiple resistance to antibiotics and other toxic chemicals. Trends in Microbiology 7:10, 410-413
CrossRef119
Pamela A Sarigiani, Lenoraann Ryan, Anne C Petersen. (1999) Prevention of high-risk behaviors in adolescent women. Journal of Adolescent Health 25:2, 109-119
CrossRef120
Robert P. Rapp. (1999) Antimicrobial Resistance in Gram-Positive Bacteria: The Myth of the MIC. Pharmacotherapy 19:8 Part 2, 112S-119S
CrossRef121
Adrian Bauman, Philayrath Phongsavan. (1999) Epidemiology of substance use in adolescence: prevalence, trends and policy implications. Drug and Alcohol Dependence 55:3, 187-207
CrossRef122
Joyce C. Chen, David M. Mannino. (1999) Worldwide epidemiology of chronic obstructive pulmonary disease. Current Opinion in Pulmonary Medicine 5:2, 93
CrossRef123
Yue Chen, James A. Dosman, Donna C. Rennie, Lori A. Lockinger. (1999) Major genetic effects on airway-parenchymal dysanapsis of the lung: The Humboldt family study. Genetic Epidemiology 16:1, 95-110
CrossRef124
E Piitulainen, T Sveger. (1998) Effect of environmental and clinical factors on lung function and respiratory symptoms in adolescents with α1-antitrypsin deficiency. Acta Paediatrica 87:11, 1120-1124
CrossRef125
Sadik A Khuder, Hari H Dayal, Anand B Mutgi, James C Willey, Gauri Dayal. (1998) Effect of cigarette smoking on major histological types of lung cancer in men. Lung Cancer 22:1, 15-21
CrossRef126
H.J.M. Smit, M. Chatrou, P.E. Postmus. (1998) The impact of spontaneous pneumothorax, and its treatment, on the smoking behaviour of young adult smokers. Respiratory Medicine 92:9, 1132-1136
CrossRef127
R Bayer, J Stryker. (1997) Ethical challenges posed by clinical progress in AIDS.. American Journal of Public Health 87:10, 1599-1602
CrossRef128
Judith R. Koopmans, Lorenz J.P. Doornen, Dorret I. Boomsma. (1997) Association between Alcohol Use and Smoking in Adolescent and Young Adult Twins: A Bivariate Genetic Analysis. Alcoholism: Clinical and Experimental Research 21:3, 537-546
CrossRef
