Cigarette smoking and asthma interact to induce important adverse effects on clinical, prognostic and therapeutic outcomes. Please read new article from Current Opinion in Pulmonary Medicine from our Greek friends dedicated to this hot Respiratory topic.
Purpose of review: The prevalence of active smoking in
adults with asthma is similar to the general population. Smoking asthma
is associated with poorer disease control, impaired response to
corticosteroid therapy, accelerated decline in lung function, and
increased rate of healthcare utilization. Current asthma guidelines do
not provide specific treatment advice for smoking asthmatic patients.
There is an urgent need for better understanding of the underlying
mechanisms and effective treatment for smoking asthmatic patients.
Recent findings: An association between both active and passive smoking and adult-onset asthma is supported by many studies.
The asthma-COPD overlap syndrome (ACOS) has recently
gained particular interest and smoking asthmatic patients should be
evaluated for ACOS.
Treatment regimens for smoking asthma include higher
doses of inhaled corticosteroids (ICS), extrafine particle ICS
formulations, antileukotrienes, and combinations of these options.
Asthma is associated with increased risk of
cardiovascular comorbidities whereas smoking is an additional strong
independent risk factor for pulmonary and cardiovascular diseases.
Tobacco smoking and not asthma per se seems to be the reason of poor
prognosis, especially with regard to lung cancer, cardiovascular
diseases, and mortality in asthmatic patients.
Summary: Smoking asthma represents a common challenge
to the clinician both in terms of diagnosis and management. These
aspects have not been thoroughly evaluated and deserve further
investigation.
Fulltext:
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