Asthma and Tobacco Smoking

Abstract

Asthma is a prevalent chronic pulmonary condition with significant morbidity and mortality. Tobacco smoking is implicated in asthma pathophysiology, diagnosis, prognosis and treatment. Smokers display increased prevalence and incidence of asthma, but a causal association cannot be claimed using existing evidence. Second-hand smoking and passive exposure to tobacco in utero and early life have also been linked with asthma development. Currently, approximately one-fourth of asthma patients are smokers. Regular smokers with asthma might display accelerated lung function decline and non-reversible airflow limitation, making their distinction from chronic obstructive pulmonary disease patients challenging. Asthma patients who smoke typically have uncontrolled disease, as shown by increased symptoms, more exacerbations and impaired quality of life. On the other hand, smoking cessation improves lung function and asthma severity. Thus, asthma patients and their caregivers should be actively questioned about their smoking status at each medical encounter, and smoking cessation ought to be strongly encouraged both for patients with asthma and their close contacts. Smokers with asthma should be provided with comprehensive smoking cessation interventions on top of other anti-asthma medications.

Frequency and characteristics of asthma in smokers attending smoking cessation units in Spain

“…Our data show a high level of passive exposure at home (40%), although without significant differences between asthmatic and non-asthmatic smokers. The relationship between passive exposure and asthma is well known [27,36,37] and is important to consider since passive exposure contributes to the adverse health outcomes presented by smokers with asthma [13,15,24,38]. Therefore, is important to involve family members to prevent smoking at home.…”

“…In this context, the physiopathological and clinical interactions between smoking and asthma have been analyzed in different studies, suggesting an ''asthma smoking phenotype" [2,3,[10][11][12][13][14]. Smoking asthmatics have different kinds of bronchial inflammation compared with non-smoking asthmatics [14].…”

“…Smoking asthmatics have different kinds of bronchial inflammation compared with non-smoking asthmatics [14]. Cigarette smoke induces important changes in the asthma endotype, with a predominance of activated macrophages and neutrophils in the sputum, airways, and lung parenchyma as in early chronic obstructive pulmonary disease [3,12,13]. The persistent exposure to cigarette smoke has been shown to drive additive or synergistic inflammatory and remodeling responses (e.g., chronic mucus hypersecretion) in the asthmatic airways, explaining the reported accelerated lung function decline and increased airflow obstruction severity [3,12,13].…”

Self-reported prevalence of asthma and its associated factors among adult rural population in Bangladesh: a cross-sectional study using WHO PEN protocol

“…Asthma patients who are current smokers have elevated disease symptoms and respiratory outcomes, affecting the quality of life. On the contrary, non-smokers and past smokers are shown to have better lung functions and less severity of asthma 25 26. Comorbidities can also make asthma management more difficult 27.…”

“…On the contrary, non-smokers and past smokers are shown to have better lung functions and less severity of asthma. 25 26 Comorbidities can also make asthma management more difficult. 27 It has been found in studies that most asthma patients live with at least one of the following comorbid condition: respiratory problems other than asthma, cardiovascular or cerebrovascular diseases, hypertension, obesity, diabetes, neurological or psychiatric conditions, urinary or gastrointestinal diseases, and cancer.…”