Chronic bronchitis in West Sweden : a matter of smoking and social class

Background: Although chronic bronchitis is associated with impaired quality of life, hospitalisations andincreased mortality, it has been less in focus after the introduction of the term chronic obstructive pulmonarydisease (COPD). There are no recent published data on the prevalence of chronic bronchitis from theScandinavian countries.Aim: The main aim of the present study was to estimate the prevalence of chronic bronchitis in West Swedenby using data from a large-scale epidemiological study of the general population. A further aim was toidentify current risk factors for chronic bronchitis in a population with a major decrease in the proportion ofsmokers.Methods: From the 18,087 questionnaire responders out of 30,000 invited to participate at the West SwedenAsthma Study, 2,000 subjects were randomly selected and invited to detailed clinical examinations performedduring 2009 2013. A total of 1,172 subjects aged 17 79 participated in the examinations which included,among others, spirometry and structured interviews. Chronic bronchitis was defined according to reportedsymptoms.Results: The overall prevalence of chronic bronchitis was 7.2% (men 7.6%; women 6.8% ns), and it was8.7% in subjects older than age 60. Chronic bronchitis was strongly associated with smoking, defined both ascurrent smoking status and pack-years. Other risk factors were increasing age, low socio-economic class andurban living. Of those with chronic bronchitis, 22% fulfilled the GOLD criteria of COPD.Conclusion: The prevalence of chronic bronchitis was somewhat lower than found by studies in Sweden in the1980s and the prevalence was now similar in men and women. Although smoking was still the dominatingrisk factor for chronic bronchitis, the relative importance of smoking had decreased parallel with a decreasingsmoking prevalence, while the relative importance of other factors than smoking had increased compared toprevious studies