Smoking is the most well-established cause of chronic airflow obstruction (CAO) but particulate air pollution and poverty have also been implicated. We regressed sex-specific prevalence of CAO from 41 Burden of Obstructive Lung Disease study sites against smoking prevalence from the same study, the gross national income per capita and the local annual mean level of ambient particulate matter (PM2.5) using negative binomial regression. The prevalence of CAO was not independently associated with PM2.5 but was strongly associated with smoking and was also associated with poverty. Strengthening tobacco control and improved understanding of the link between CAO and poverty should be prioritised.
Andre F S Amaral, Peter G J Burney, Jaymini Patel, Cosetta Minelli, Filip Mejza, David M Mannino, Terence A R Seemungal, Padukudru Anand Mahesh, Li Cher Lo, Christer Janson, Sanjay Juvekar, Meriam Denguezli, Imed Harrabi, Emiel F M Wouters, Hamid Cherkaski, Kevin Mortimer, Rain Jogi, Eric D Bateman, Elaine Fuertes, Mohammed Al Ghobain, Wan Tan, Daniel O Obaseki, Asma El Sony, Michael Studnicka, Althea Aquart-Stewart, Parvaiz Koul, Herve Lawin, Asaad Ahmed Nafees, Olayemi Awopeju, Gregory E Erhabor, Thorarinn Gislason, Tobias Welte, Amund Gulsvik, Rune Nielsen, Louisa Gnatiuc, Ali Kocabas, Guy B Marks, Talant Sooronbaev, Bertrand Hugo Mbatchou Ngahane, Cristina Barbara, A Sonia Buist, BOLD (Burden of Obstructive Lung Disease) Collaborative Research Group, BOLD (Burden of Obstructive Lung Disease) Collaborative Research Group members