Association between population prevalence of smoking and incidence of meningococcal disease in Norway, Sweden, Denmark and the Netherlands between 1975 and 2009

A population-based time series analysis

Gunnstein Norheim, Manish Sadarangani, Omar Omar, Ly Mee Yu, Kåre Mølbak, Michael Howitz, Per Olcén, Margaretha Haglund, Arie Van Der Ende, Andrew J. Pollard

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objective: To investigate the relationship between the prevalence of smoking in the population and incidence of invasive meningococcal disease (IMD) among children under 5 years of age. Design: Retrospective, longitudinal, observational study. Poisson regression controlled for confounding factors. Setting: Norway, Sweden, Denmark and the Netherlands between 1975 and 2009. Population: Total population of approximately 35 million people in these four countries. Data sources: Data were collected from the Ministries of Health, National Statistics Bureaus and other relevant national institutes. Results: In Norway, there was a significant positive relationship between the annual prevalence of daily smokers among individuals aged 25-49 years and the incidence of IMD in children under 5 years of age, unadjusted (RR=1.04-1.06, 95% CI 1.02 to 1.07, p<0.001) and after adjustment for time of year (quarter), incidence of influenza-like illness and household crowding (RR=1.05-1.07, 95% CI 1.03 to 1.09, p<0.001). Depending on age group, the risk of IMD increased by 5.2-6.9% per 1% increase in smoking prevalence among individuals aged 25-49 years in adjusted analyses. Using limited datasets from the three other countries, unadjusted analysis showed positive associations between IMD in children related to older smokers in Sweden and the Netherlands and negative associations related to younger smokers in Sweden. However, there were no demonstrable associations between incidence of IMD and prevalence of smoking, after adjustment for the same confounding variables. Conclusions: The reduced incidence of IMD in Norway between 1975 and 2009 may partly be explained by the reduced prevalence of smoking during this period. High-quality surveillance data are required to confirm this in other countries. Strong efforts to reduce smoking in the whole population including targeted campaigns to reduce smoking among adults may have a role to play in the prevention of IMD in children.

Original languageEnglish
Article numbere003312
JournalBMJ Open
Volume4
Issue number2
DOIs
Publication statusPublished - 4 Mar 2014
Externally publishedYes

Fingerprint

Denmark
Norway
Sweden
Netherlands
Smoking
Incidence
Population
Crowding
Confounding Factors (Epidemiology)
Information Storage and Retrieval
Human Influenza
Observational Studies
Longitudinal Studies
Age Groups
Health

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Association between population prevalence of smoking and incidence of meningococcal disease in Norway, Sweden, Denmark and the Netherlands between 1975 and 2009 : A population-based time series analysis. / Norheim, Gunnstein; Sadarangani, Manish; Omar, Omar; Yu, Ly Mee; Mølbak, Kåre; Howitz, Michael; Olcén, Per; Haglund, Margaretha; Van Der Ende, Arie; Pollard, Andrew J.

In: BMJ Open, Vol. 4, No. 2, e003312, 04.03.2014.

Research output: Contribution to journalArticle

Norheim, Gunnstein ; Sadarangani, Manish ; Omar, Omar ; Yu, Ly Mee ; Mølbak, Kåre ; Howitz, Michael ; Olcén, Per ; Haglund, Margaretha ; Van Der Ende, Arie ; Pollard, Andrew J. / Association between population prevalence of smoking and incidence of meningococcal disease in Norway, Sweden, Denmark and the Netherlands between 1975 and 2009 : A population-based time series analysis. In: BMJ Open. 2014 ; Vol. 4, No. 2.
@article{2b3ff75702d14b4d932f371fcb366ea7,
title = "Association between population prevalence of smoking and incidence of meningococcal disease in Norway, Sweden, Denmark and the Netherlands between 1975 and 2009: A population-based time series analysis",
abstract = "Objective: To investigate the relationship between the prevalence of smoking in the population and incidence of invasive meningococcal disease (IMD) among children under 5 years of age. Design: Retrospective, longitudinal, observational study. Poisson regression controlled for confounding factors. Setting: Norway, Sweden, Denmark and the Netherlands between 1975 and 2009. Population: Total population of approximately 35 million people in these four countries. Data sources: Data were collected from the Ministries of Health, National Statistics Bureaus and other relevant national institutes. Results: In Norway, there was a significant positive relationship between the annual prevalence of daily smokers among individuals aged 25-49 years and the incidence of IMD in children under 5 years of age, unadjusted (RR=1.04-1.06, 95{\%} CI 1.02 to 1.07, p<0.001) and after adjustment for time of year (quarter), incidence of influenza-like illness and household crowding (RR=1.05-1.07, 95{\%} CI 1.03 to 1.09, p<0.001). Depending on age group, the risk of IMD increased by 5.2-6.9{\%} per 1{\%} increase in smoking prevalence among individuals aged 25-49 years in adjusted analyses. Using limited datasets from the three other countries, unadjusted analysis showed positive associations between IMD in children related to older smokers in Sweden and the Netherlands and negative associations related to younger smokers in Sweden. However, there were no demonstrable associations between incidence of IMD and prevalence of smoking, after adjustment for the same confounding variables. Conclusions: The reduced incidence of IMD in Norway between 1975 and 2009 may partly be explained by the reduced prevalence of smoking during this period. High-quality surveillance data are required to confirm this in other countries. Strong efforts to reduce smoking in the whole population including targeted campaigns to reduce smoking among adults may have a role to play in the prevention of IMD in children.",
author = "Gunnstein Norheim and Manish Sadarangani and Omar Omar and Yu, {Ly Mee} and K{\aa}re M{\o}lbak and Michael Howitz and Per Olc{\'e}n and Margaretha Haglund and {Van Der Ende}, Arie and Pollard, {Andrew J.}",
year = "2014",
month = "3",
day = "4",
doi = "10.1136/bmjopen-2013-003312",
language = "English",
volume = "4",
journal = "BMJ Open",
issn = "2044-6055",
publisher = "BMJ Publishing Group",
number = "2",

}

TY - JOUR

T1 - Association between population prevalence of smoking and incidence of meningococcal disease in Norway, Sweden, Denmark and the Netherlands between 1975 and 2009

T2 - A population-based time series analysis

AU - Norheim, Gunnstein

AU - Sadarangani, Manish

AU - Omar, Omar

AU - Yu, Ly Mee

AU - Mølbak, Kåre

AU - Howitz, Michael

AU - Olcén, Per

AU - Haglund, Margaretha

AU - Van Der Ende, Arie

AU - Pollard, Andrew J.

PY - 2014/3/4

Y1 - 2014/3/4

N2 - Objective: To investigate the relationship between the prevalence of smoking in the population and incidence of invasive meningococcal disease (IMD) among children under 5 years of age. Design: Retrospective, longitudinal, observational study. Poisson regression controlled for confounding factors. Setting: Norway, Sweden, Denmark and the Netherlands between 1975 and 2009. Population: Total population of approximately 35 million people in these four countries. Data sources: Data were collected from the Ministries of Health, National Statistics Bureaus and other relevant national institutes. Results: In Norway, there was a significant positive relationship between the annual prevalence of daily smokers among individuals aged 25-49 years and the incidence of IMD in children under 5 years of age, unadjusted (RR=1.04-1.06, 95% CI 1.02 to 1.07, p<0.001) and after adjustment for time of year (quarter), incidence of influenza-like illness and household crowding (RR=1.05-1.07, 95% CI 1.03 to 1.09, p<0.001). Depending on age group, the risk of IMD increased by 5.2-6.9% per 1% increase in smoking prevalence among individuals aged 25-49 years in adjusted analyses. Using limited datasets from the three other countries, unadjusted analysis showed positive associations between IMD in children related to older smokers in Sweden and the Netherlands and negative associations related to younger smokers in Sweden. However, there were no demonstrable associations between incidence of IMD and prevalence of smoking, after adjustment for the same confounding variables. Conclusions: The reduced incidence of IMD in Norway between 1975 and 2009 may partly be explained by the reduced prevalence of smoking during this period. High-quality surveillance data are required to confirm this in other countries. Strong efforts to reduce smoking in the whole population including targeted campaigns to reduce smoking among adults may have a role to play in the prevention of IMD in children.

AB - Objective: To investigate the relationship between the prevalence of smoking in the population and incidence of invasive meningococcal disease (IMD) among children under 5 years of age. Design: Retrospective, longitudinal, observational study. Poisson regression controlled for confounding factors. Setting: Norway, Sweden, Denmark and the Netherlands between 1975 and 2009. Population: Total population of approximately 35 million people in these four countries. Data sources: Data were collected from the Ministries of Health, National Statistics Bureaus and other relevant national institutes. Results: In Norway, there was a significant positive relationship between the annual prevalence of daily smokers among individuals aged 25-49 years and the incidence of IMD in children under 5 years of age, unadjusted (RR=1.04-1.06, 95% CI 1.02 to 1.07, p<0.001) and after adjustment for time of year (quarter), incidence of influenza-like illness and household crowding (RR=1.05-1.07, 95% CI 1.03 to 1.09, p<0.001). Depending on age group, the risk of IMD increased by 5.2-6.9% per 1% increase in smoking prevalence among individuals aged 25-49 years in adjusted analyses. Using limited datasets from the three other countries, unadjusted analysis showed positive associations between IMD in children related to older smokers in Sweden and the Netherlands and negative associations related to younger smokers in Sweden. However, there were no demonstrable associations between incidence of IMD and prevalence of smoking, after adjustment for the same confounding variables. Conclusions: The reduced incidence of IMD in Norway between 1975 and 2009 may partly be explained by the reduced prevalence of smoking during this period. High-quality surveillance data are required to confirm this in other countries. Strong efforts to reduce smoking in the whole population including targeted campaigns to reduce smoking among adults may have a role to play in the prevention of IMD in children.

UR - http://www.scopus.com/inward/record.url?scp=84896829587&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84896829587&partnerID=8YFLogxK

U2 - 10.1136/bmjopen-2013-003312

DO - 10.1136/bmjopen-2013-003312

M3 - Article

VL - 4

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

IS - 2

M1 - e003312

ER -