JF Price

Abstract

Injury to the growing lung may influence the development of chest disease in the later life. Three potentially harmful factors are passive smoking, premature birth and acute lower respiratory tract infection. These factors contribute to the spectrum of wheezing in early childhood but probably make a relatively small impact on the prevalence of asthma in adults. They may however increase vulnerability to COPD by affecting normal development of lung function in childhood and adolescence. Young adults who have been exposed to cigarette smoke since foetal life, were of low birthweight or who contracted severe bacterial or viral lower respiratory infection as young children, frequently show persisting airways obstruction. This is not reversible with a bronchodilatator and suggests a failure to attain maximal lung function. Exposure to tobacco products also increases vulnerability to respiratory infection in childhood. The cycle is carried to the next generation through smoking in pregnancy.