Tuberc Respir Dis.  2009 Dec;67(6):506-511.

Clinical Characteristics of Smoking Asthmatics

Affiliations
  • 1Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. khin@kumc.or.kr

Abstract

BACKGROUND
The smoking prevalence in asthma patients are similar to those in the general population. Asthma and active cigarette smoking can interact to create more severe symptoms, an accelerated decline in lung function and impaired therapeutic responses. Accordingly, asthmatics with a history of smoking were examined to define the clinical characteristics and lung function of smoking asthmatics. METHODS: The medical records of 142 asthmatics with a known smoking history were reviewed. The patients were divided into three groups according to their smoking history - current smokers, former smokers and non-smokers. The clinical characteristics, lung function, and annual declines of the forced expiratory volume in one second (FEV1) were compared. RESULTS: Fifty-three of the 142 patients (37%) were current smokers, 24 were former smokers (17%) and 65 were non-smokers (45%). The patients with a hospital admission history during the previous year included 16 current smokers (30%), 4 former smokers (17%) and 7 non-smokers (11%) (p=0.02). The mean FEV1 (% predicted) was 76.8+/-19.8%, 71.6+/-21.1% and 87.9+/-18.7% for current smokers, former smokers and non-smokers, respectively (p<0.001). The FEV1/forced vital capacity (FVC) (ratio, %) values were 63.6+/-12.6%, 59.3+/-14.9% and 72.1+/-11.8% in current smokers, former smokers and non-smokers, respectively (p<0.001). The corresponding mean values for the individual FEV1 slopes were not significant (p=0.33). CONCLUSION: Asthmatic smokers demonstrated higher hospital admission rates and lower lung function. These findings suggest that the smoking history is an important predictor of a poor clinical outcome in asthma patients.

Keyword

Smoking; Asthma; Respiratory Function Tests; Diseases Progression

MeSH Terms

Asthma
Forced Expiratory Volume
Humans
Lung
Medical Records
Prevalence
Respiratory Function Tests
Smoke
Smoking
Vital Capacity
Smoke

Reference

1. Thomson NC, Chaudhuri R, Livingston E. Asthma and cigarette smoking. Eur Respir J. 2004. 24:822–833.
2. Korea National Statistical Office. Report on the social statistics survey 2007. 2008. Daejeon: Korea National Statistical Office.
3. Althuis MD, Sexton M, Prybylski D. Cigarette smoking and asthma symptom severity among adult asthmatics. J Asthma. 1999. 36:257–264.
4. Lange P, Parner J, Vestbo J, Schnohr P, Jensen G. A 15-year follow-up study of ventilatory function in adults with asthma. N Engl J Med. 1998. 339:1194–1200.
5. Siroux V, Pin I, Oryszczyn MP, Le Moual N, Kauffmann F. Relationships of active smoking to asthma and asthma severity in the EGEA study. Epidemiological study on the Genetics and Environment of Asthma. Eur Respir J. 2000. 15:470–477.
6. Haahtela T. Lung function decline in asthma and early intervention with inhaled corticosteroids. Chest. 2006. 129:1405–1406.
7. Prescott E, Lange P, Vestbo J. Effect of gender on hospital admissions for asthma and prevalence of self-reported asthma: a prospective study based on a sample of the general population. Copenhagen City Heart Study Group. Thorax. 1997. 52:287–289.
8. Sippel JM, Pedula KL, Vollmer WM, Buist AS, Osborne ML. Associations of smoking with hospital-based care and quality of life in patients with obstructive airway disease. Chest. 1999. 115:691–696.
9. Silverman RA, Boudreaux ED, Woodruff PG, Clark S, Camargo CA Jr. Cigarette smoking among asthmatic adults presenting to 64 emergency departments. Chest. 2003. 123:1472–1479.
10. Cassino C, Ito K, Bader I, Ciotoli C, Thurston G, Reibman J. Cigarette smoking and ozone-associated emergency department use for asthma by adults in New York City. Am J Respir Crit Care Med. 1999. 159:1773–1779.
11. Marquette CH, Saulnier F, Leroy O, Wallaert B, Chopin C, Demarcq JM, et al. Long-term prognosis of near-fatal asthma. A 6-year follow-up study of 145 asthmatic patients who underwent mechanical ventilation for a near-fatal attack of asthma. Am Rev Respir Dis. 1992. 146:76–81.
12. National Heart Lung and Blood Institute. National Institutes of Health (USA). World Health Organization. The Global Initiative for Asthma (GINA) [Internet]. c2009. cited 2009 Oct 26. [place unknown]: GINA;Available from: http://www.ginasthma.com.
13. Chalmers GW, Macleod KJ, Little SA, Thomson LJ, McSharry CP, Thomson NC. Influence of cigarette smoking on inhaled corticosteroid treatment in mild asthma. Thorax. 2002. 57:226–230.
14. Chaudhuri R, Livingston E, McMahon AD, Thomson L, Borland W, Thomson NC. Cigarette smoking impairs the therapeutic response to oral corticosteroids in chronic asthma. Am J Respir Crit Care Med. 2003. 168:1308–1311.
15. Boulet LP, Lemiere C, Archambault F, Carrier G, Descary MC, Deschesnes F. Smoking and asthma: clinical and radiologic features, lung function, and airway inflammation. Chest. 2006. 129:661–668.
16. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005. 26:319–338.
17. Cibella F, Cuttitta G, Bellia V, Bucchieri S, D'Anna S, Guerrera D, et al. Lung function decline in bronchial asthma. Chest. 2002. 122:1944–1948.
18. Dijkstra A, Vonk JM, Jongepier H, Koppelman GH, Schouten JP, ten Hacken NH, et al. Lung function decline in asthma: association with inhaled corticosteroids, smoking and sex. Thorax. 2006. 61:105–110.
Full Text Links
  • TRD
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr