An Analysis of the Pulmonary Function in Smokers and Non-Smokers Among College Students

Introduction

There is an estimation that globally six million people are dying annually due to cigarettes.¹² Irrespective of the areas they live in i.e., urban and rural, smoking became habitual in Indian population in many ways.² By mid-2030, tobacco related deaths would rise to 10 million a year.¹³ Cigarette smoking affects respiratory function and is an obvious implication of various respiratory infections, especially chronic bronchitis, emphysema, and bronchial carcinoma.¹¹ Cigarette smoking has been an initial cause of impaired pulmonary function. Smoking, either actively or passively, has cynical effect on lung function.¹ Smoking is related with a risk of about 50+ diagnosed diseases and is an essential driver of numerous normal ailments including malignancy, cardio-respiratory illness and chronic obstructive pulmonary disease (COPD).⁷

Pulmonary function helps in respiration, the process by which cells utilize oxygen and carbon- dioxide and exchange the gases with the atmosphere. Surfactant present in the lungs helps breathing efficiency. The lungs maintain normal respiratory gases press and contents in the arterial blood in homeostasis. Constant arterial blood gases are maintained by required amount of exchange of gases between alveolar air and blood passing through the alveolar capillaries. Lung function is important to maintain pH balance to maintain the rate of ventilation.

Aim of the study

The aim of the present investigation is to identify the lung functioning in smoking and non-smoking college students.

Objectives of the study

To evaluate the respiratory function in smoking and non-smoking college students. The proposed null hypothesis was that there would not be any significant variation in the pulmonary function among smoking and non-smoking college students. The alternate hypothesis proposed was that there would be a notable variation in the respiratory function in smokers and non-smokers among college students.

Methodology

Characterization criteria as given by WHO (1998)14

• Smoker: smoking during this examination, either every day or infrequently.
• Non-Smoker: does not smoke at the time of the research at all.
• Ex-Smoker: one who used to smoke but now does not smoke at all.

Smoking Index (SI): The Sl is equivalent to the product of the normal mean number of cigarettes puffed & inhaled daily and time period (in long term) of tobacco smoking. Later smokers were ranked as per their level of exposing to cigarette smoking based on Sl criteria.^8,9

The Lung Function Questionnaire has been demonstrated as an useful AO case-discovering instrument with an expected COPD pervasiveness of 17.9% in the objective example of smokers.³ The LFQ was created and initially approved utilizing a paper-based (P) method of organization in a random sampling examination at two essential consideration in which screening properties, scoring and different psychometrics were investigated.¹⁰

The present case-control study included a convenience sample of 50 subjects in the age group of 18-25 years recruited from a college. They comprised of 25 smokers and 25 non-smokers. Individuals with history of smoking were categorised as smokers i.e., case group and control group included non-smokers. Both males and females were included because the cigarette smoking slows down the growing level of lung functioning in female as they are more vulnerable than males. Individuals with upper respiratory tract infections, recent lung pathologies and respiratory disorders were excluded from the study.

Informed consent was obtained for all the subjects. The copyright permission was taken from GlaxoSmithKline for use of LFQ in the study and the questionnaire was distributed among the participants.

Outcome measure

A self-reported lung function using Lung Function Questionnaire³ (LFQ) was taken. The lung function questionnaire is a 5-item questionnaire in which three items helps to rule out lung function whereas one item rules out if the participant is a smoker or a non-smoker and another item is regarding age group. A score less than 18 indicates increased risk of chronic obstructive pulmonary diseases.

Analysis

Risk Facto *Status Cross tabulation

Results

The results show that the overall risk is less as the odds ratio from no risk upon. Risk is more than I but in case of smokers the risk is high.

Discussion

Although the study results were obtained from a small sample, it showed significant effects of smoking on pulmonary function in young adults. Though there are many studies that provide evidence that pulmonary function may be affected by any triggering factor, not much of evidence is available to say that non-smokers are equally affected. This study provides evidence that even non-smokers are affected, while smokers are affected in a higher proportion.

There are very few studies that were conducting in college students in India regarding pulmonary function with majority of studies conducted among adolescents and adults. This study provides an overview of functioning of lung in smokers and non-smokers among college students.

Cigarette smoking is by a wide margin the most significant hazard factor for COPD and tobacco significantly increases the danger of COPD.

The decrease in lung function in young adults also depends on the age at which they started smoking habit. Inhaling of tobacco smoke has demonstrated initial intense changes in pulmonary function like differences in resisted airflow, coughing, and disturbances in the airways. This research findings may empower the execution of smoking discontinuance counselling for young adults.¹⁶

Limitations

The limitation of the present study is that it was conducted only among college students and measured only single outcome.

Implications

The study can be useful for further research studies involving interventions for improving the pulmonary function. Other outcome measures can be used to improve the study and for the better analysis for future studies.

Future scope

The information from this study could be used in rehabilitation centres for finding the individuals at risk for developing respiratory problems and educating them for cessation of smoking.

Conclusion

The study concludes that the lung function in smokers is affected more than the non-smokers. However, even non-smokers could get affected due to passive smoking. Smoking has a deleterious impact on the functioning of lung in young adults. This could be prevented by health educational programs creating awareness among the students regarding smoking and its impact on the respiratory function and on the physical growth.

Conflicts of Interest

Authors declare that there is no conflict of interest.