{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:48:10Z","timestamp":1781484490240,"version":"3.54.1"},"reference-count":27,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T00:00:00Z","timestamp":1631577600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["HHSN271201100027C"],"award-info":[{"award-number":["HHSN271201100027C"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The purpose of this study is to validate the seven-item wheezing module from the International Study of Asthma and Allergies in Children (ISAAC) in the nationally representative Population Assessment of Tobacco and Health Study. Adult participants with complete Wave 2\u20133 data were selected, including those with asthma but excluding those with COPD and other respiratory diseases (n = 16,295). We created a nine-point respiratory symptom index from the ISAAC questions, assessed the reliability of the index, and examined associations with self-reported asthma diagnosis. Threshold values were assessed for association with functional outcomes. The weighted prevalence for one or more respiratory symptom was 18.0% (SE = 0.5) for adults without asthma, 70.1% (SE = 1.3) for those with lifetime asthma, 75.7% (SE = 3.7) for adults with past-year asthma not on medications, and 92.6% (SE = 1.6) for those on medications. Cronbach\u2019s alpha for the respiratory symptom index was 0.86. Index scores of \u22652 or \u22653 yielded functionally important respiratory symptom prevalence of 7\u201310%, adequate sensitivity and specificity for identifying asthma, and consistent independent associations with all functional outcomes and tobacco use variables. Respiratory symptom index scores of \u22652 or \u22653 are indicative of functionally important respiratory symptoms and could be used to assess the relationship between tobacco use and respiratory health.<\/jats:p>","DOI":"10.3390\/ijerph18189688","type":"journal-article","created":{"date-parts":[[2021,9,14]],"date-time":"2021-09-14T23:34:11Z","timestamp":1631662451000},"page":"9688","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Validation of an Index for Functionally Important Respiratory Symptoms among Adults in the Nationally Representative Population Assessment of Tobacco and Health Study, 2014\u20132016"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8703-3811","authenticated-orcid":false,"given":"Michael J.","family":"Halenar","sequence":"first","affiliation":[{"name":"Westat, Rockville, MD 20850, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James D.","family":"Sargent","sequence":"additional","affiliation":[{"name":"Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, NH 03755, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn C.","family":"Edwards","sequence":"additional","affiliation":[{"name":"Westat, Rockville, MD 20850, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Woloshin","sequence":"additional","affiliation":[{"name":"Dartmouth Institute for Health Policy and Clinical Practice, The C. Everett Koop Institute at Dartmouth, The Lisa Schwartz Foundation, Lebanon, NH 03766, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa","family":"Schwartz","sequence":"additional","affiliation":[{"name":"Dartmouth Institute for Health Policy and Clinical Practice, The C. Everett Koop Institute at Dartmouth, The Lisa Schwartz Foundation, Lebanon, NH 03766, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Emond","sequence":"additional","affiliation":[{"name":"Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, NH 03755, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5077-8337","authenticated-orcid":false,"given":"Susanne","family":"Tanski","sequence":"additional","affiliation":[{"name":"Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, NH 03755, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John P.","family":"Pierce","sequence":"additional","affiliation":[{"name":"Moores Cancer Center, University of California at San Diego, La Jolla, CA 92037, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristie A.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Westat, Rockville, MD 20850, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin","family":"Lauten","sequence":"additional","affiliation":[{"name":"Westat, Rockville, MD 20850, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6748-3068","authenticated-orcid":false,"given":"Maciej L.","family":"Goniewicz","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0856-3540","authenticated-orcid":false,"given":"Raymond","family":"Niaura","sequence":"additional","affiliation":[{"name":"School of Global Public Health, New York University, New York, NY 10012, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriella","family":"Anic","sequence":"additional","affiliation":[{"name":"Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanling","family":"Chen","sequence":"additional","affiliation":[{"name":"Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4076-9247","authenticated-orcid":false,"given":"Priscilla","family":"Callahan-Lyon","sequence":"additional","affiliation":[{"name":"Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3340-2818","authenticated-orcid":false,"given":"Lisa D.","family":"Gardner","sequence":"additional","affiliation":[{"name":"Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theresa","family":"Thekkudan","sequence":"additional","affiliation":[{"name":"Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolette","family":"Borek","sequence":"additional","affiliation":[{"name":"Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD 20993, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8278-0095","authenticated-orcid":false,"given":"Heather L.","family":"Kimmel","sequence":"additional","affiliation":[{"name":"National Institute on Drug Abuse, National Institutes of Health, Bethesda, MD 20852, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7103-7017","authenticated-orcid":false,"given":"K. Michael","family":"Cummings","sequence":"additional","affiliation":[{"name":"Department of Psychiatry & Behavioral Science, Medical University of South Carolina, Mt. Pleasant, SC 29464, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Hyland","sequence":"additional","affiliation":[{"name":"Department of Health Behavior, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14203, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0713-8745","authenticated-orcid":false,"given":"Mary F.","family":"Brunette","sequence":"additional","affiliation":[{"name":"Geisel School of Medicine at Dartmouth, The C. Everett Koop Institute at Dartmouth, Hanover, NH 03755, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,9,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1001\/archinte.160.11.1683","article-title":"Obstructive lung disease and low lung function in adults in the United States: Data from the National Health and Nutrition Examination Survey, 1988-1994","volume":"160","author":"Mannino","year":"2000","journal-title":"Arch. Intern. 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