Cigarette Smoking and Asthma Symptom Severity Among Adult Asthmatics

Abstract

Contrary to what would be expected, smoking habits of asthmatics do not differ from those of the general population: approximately 30% of asthmatic patients smoke cigarettes. Although the relationship between smoking and the incidence of asthma has been well explored, little attention has been paid to documenting the relationship between smoking and asthma symptoms among adults with asthma. The objective of this study was to assess the association of cigarette smoking with asthma symptom severity. The present report is of a cross-sectional study of 225 asthmatics, aged 20-54 years, from six general practice clinics in East Anglia, U.K. The outcome measures are overall asthma symptom score (range 6.3-28) and three asthma symptom domains: respiratory (range 1.3-8), daily activity interference (range 2-8), and physical activity interference (range 3-12), generated from the sum of ordinal responses to questions on asthma symptom severity. Of the sample, 27.0% were current and 22.1% were former smokers. Current smokers more frequently had bothersome asthma symptoms than nonsmokers in both unadjusted analyses and analyses controlling for age, gender, recent visits to the general practitioner for asthma, and asthma medication use (p = 0.06). Respiratory symptoms (p = 0.03) and symptoms that affect daily activities (p = 0.03) were more strongly associated with smoking than symptoms that affect physical activities (p = 0.62). Our data suggest that smoking hastens asthma progression or affects disease control. Increased frequency of symptoms may be an indicator for potential morbidity among asthmatics, especially those who smoke cigarettes. The hazards associated with smoking among asthmatics need to be more clearly emphasized by physicians and public health officials in order to convince people with asthma who smoke to stop.

Clinical Characteristics of Smoking Asthmatics

“…There was no significant difference in the number of patients who made unscheduled outpatient clinic visits for treatment within the previous three months, which is a gauge used to determine the recent aggravation of asthma symptoms. This differed from previous results possibly for reasons similar to the results obtained for oral corticosteroid use 3,5 . In the present study, current and former smokers used significantly more medication (i.e., leukotriene and theophylline) than non-smokers (p=0.03, p=0.02) presumably because smokers need more medication to control asthma symptoms.…”

“…Asthmatic smokers are also more likely to require hospital care than asthmatic non-smokers [7][8][9][10] . Furthermore, asthma-related morbidity and mortality is higher among smokers Original Article than non-smokers 3,11 . Corticosteroids, especially inhaled corticosteroids, are currently the best anti-inflammatory therapy available for the treatment of asthma, and their use is recommended by the Global Initiative for Asthma (GINA) 12 .…”

“…Adults with asthma who smoke cigarettes exhibit more severe asthmatic symptoms and demonstrate a more rapid decline in pulmonary function [3][4][5][6] . Asthmatic smokers are also more likely to require hospital care than asthmatic non-smokers [7][8][9][10] .…”

Effect of obesity on asthma among adult Indian women

“…52 The finding that active tobacco smoking is associated with significantly increased risk of asthma is also consistent with previous research. [53][54][55][56] However, active tobacco smoking is not a major confounder in this study because only a small proportion of women in India smoke tobacco (only 2.3% in the NFHS-2 sample). 4 A positive significant effect of biomass fuel use on asthma is also consistent with previous research linking cooking smoke to asthma.…”

Effect of Indoor Air Pollution from Biomass and Solid Fuel Combustion on Prevalence of Self-Reported Asthma among Adult Men and Women in India: Findings from a Nationwide Large-Scale Cross-Sectional Survey

“…Several studies have found that exposure to tobacco smoke can increase the frequency and severity of asthmatic attacks (69)(70)(71), but some fail to link tobacco smoking to onset of asthma in adults (72,73). Smoking has been associated with airway hyperresponsiveness in a number of surveys as well as in clinical studies (27,(73)(74)(75)(76).…”