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This study was undertaken to determine the effects of passive exposure to tobacco smoke and respiratory syncitial virus (RSV) lower respiratory infection (LRI) during infancy on the occurrence of BHR in the first 2 years of life. Eighty\u2010six cases of documented RSV (mean age, 188 days) and 78 controls (mean age, 162 days) were enrolled from the clinic and in\u2010patient service of a single hospital. None had a history of prior LRI. Subjects were studied at 6\u2010month intervals up to 19 months of age with a standardized respiratory illness and parental smoking questionnaire, partial expiratory flow\u2010volume curves by the \u201chug\u201d (rapid thoracic compression) technique, and methacholine challenge.<\/jats:p><jats:p>Exposure to maternal and paternal cigarette smoking, maternal history of asthma, and mold exposure were associated with decreased levels of length\u2010corrected maximal flow at functional residual capacity (V\u2032<jats:sub>maxFRC<\/jats:sub>). RSV\u2010LRI was not related to V\u2032<jats:sub>maxFRC<\/jats:sub>. After adjustment of V\u2032<jats:sub>maxFRC<\/jats:sub> for these factors, V\u2032<jats:sub>maxFRC<\/jats:sub> was a significantly and positively correlated with a methacholine concentration provoking a 40% fall in V\u2032<jats:sub>maxFRC<\/jats:sub> (PC40) and negatively correlated with dose\u2010response slope. After adjustment for V\u2032<jats:sub>maxFRC<\/jats:sub>, there were no independent effects of tobacco smoke exposure or RSV\u2010LRI on methacholine responses.<\/jats:p><jats:p>These data do not support a role for RSV as a risk factor for airways reactivity in childhood and indicate that exposure to tobacco smoke affects airways reactivity through its effects on airways. Pediatr Pulmonol. 2001; 32:418\u2013427. \u00a9 2001 Wiley\u2010Liss, Inc.<\/jats:p>","DOI":"10.1002\/ppul.1153","type":"journal-article","created":{"date-parts":[[2002,8,25]],"date-time":"2002-08-25T19:52:11Z","timestamp":1030305131000},"page":"418-427","source":"Crossref","is-referenced-by-count":28,"title":["Association of tobacco smoke exposure and respiratory syncitial virus infection with airways reactivity in early childhood"],"prefix":"10.1002","volume":"32","author":[{"given":"Alan","family":"Adler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Long","family":"Ngo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ira 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