Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Respiratory Research
Published in: Respiratory Research 1/2011

Open Access 01-12-2011 | Research

Greater severity of new onset asthma in allergic subjects who smoke: a 10-year longitudinal study

Authors: Riccardo Polosa, Cristina Russo, Pasquale Caponnetto, Gaetano Bertino, Maria Sarvà, Tjana Antic, Stefania Mancuso, Wael K Al-Delaimy

Published in: Respiratory Research | Issue 1/2011

Login to get access

Abstract

Background

Little is known about the association between cigarette smoking and asthma severity. We assessed smoking as a determinant of disease severity and control in a cohort of clinic-referred allergic subjects who developed new onset asthma.

Methods

Allergic rhinitis subjects with no asthma (n = 371) were followed-up for 10 years and routinely examined for asthma diagnosis. In those who developed asthma (n = 152), clinical severity and levels of asthma control were determined. Among these subjects, 74 (48.7%) were current smokers, 17 (11.2%) former smokers, and 61 (40.1%) never smokers.

Results

When comparing current or past smokers to never smokers they had a higher risk of severe asthma in the univariate analysis, which became non-significant in the multivariate analysis. On the other hand, the categories of pack-years were significantly related to severe asthma in a dose response relationship in both the univariate and multivariate analysis: compared to 0 pack years, those who smoked 1-10 pack-years had an OR(95% CI) of 1.47(0.46-4.68), those who smoked 11-20 pack-years had an OR of 2.85(1.09-7.46) and those who smoked more than 20 pack-years had an OR of 5.59(1.44-21.67) to develop more severe asthma. Smokers with asthma were also more likely to have uncontrolled disease. A significant dose-response relationship was observed for pack-years and uncontrolled asthma. Compared to 0 pack years, those who smoked 1-10 pack-years had an OR of 5.51(1.73-17.54) and those who smoked more than 10 pack-years had an OR of 13.38(4.57-39.19) to have uncontrolled asthma.

Conclusions

The current findings support the hypothesis that cigarette smoking is an important predictor of asthma severity and poor asthma control.
Appendix
Available only for authorised users
Literature
1.
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. 10.1056/NEJM199810223391703.CrossRefPubMed
2.
Apostol G, Jacobs D, Tsai A, Crow R, Williams O, Townsend M, Beckett W: Early life factors contribute to the decrease in lung function between ages 18 and 40. Am J Respir Crit Care Med. 2002, 166: 166-172. 10.1164/rccm.2007035.CrossRefPubMed
3.
James AL, Palmer LJ, Kicic E, Maxwell PS, Lagan SE, Ryan GF, Musk AW: Decline in Lung Function in the Busselton Health Study: the Effects of Asthma and Cigarette Smoking. Am J Respir Crit Care Med. 2005, 171 (2): 109-14. 10.1164/rccm.200402-230OC.CrossRefPubMed
4.
Siroux V, Pin I, Oryszcyn MP, Le Moual N, Kauffmann F: Relationships of active smoking to asthma and asthma severity in the EGEA study. Eur Respir J. 2000, 15: 470-477. 10.1034/j.1399-3003.2000.15.08.x.CrossRefPubMed
5.
Austin JB, Selvaraj S, Godden D, Russell G: Deprivation, smoking, and quality of life in asthma. Arch. Dis. Child. 2005, 90: 253-257. 10.1136/adc.2004.049346.CrossRefPubMedPubMedCentral
6.
Eisner MD, Iribarren C: The influence of cigarette smoking on adult asthma outcomes. Nicotine Tob Res. 2007, 9 (1): 53-6. 10.1080/14622200601078293.CrossRefPubMed
7.
Marquette C, Saulnier F, Leroy O, Wallaert B, Chopin C, Demarcq J, Durocher A, Tonnel A: Long-term prognosis of near-fatal asthma. Am Rev Resp Dis. 1992, 146: 76-81.CrossRefPubMed
8.
Ulrik CS, Frederiksen J: Mortality and markers of risk of asthma death among 1075 outpatients with asthma. Chest. 1995, 108: 10-15. 10.1378/chest.108.1.10.CrossRefPubMed
9.
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. 10.1164/rccm.200304-503OC.CrossRefPubMed
10.
Tomlinson JEM, McMahon AD, Chaudhuri R, Thompson JM, Wood SF, Thomson NC: Efficacy of low and high dose inhaled corticosteroid in smokers versus non-smokers with mild asthma. Thorax. 2005, 60: 282-287. 10.1136/thx.2004.033688.CrossRefPubMedPubMedCentral
11.
Lazarus SC, Chinchilli VM, Rollings NJ, Boushey HA, Cherniack R, Craig TJ, Deykin A, Dimango E, Fish JE, Ford JG, Israel E, Kiley J, Kraft M, Lemanske RF, Leone FT, Martin RJ, Pesola GR, Peters SP, Sorkness CA, Szefler SJ, Wechsler ME, Fahy JV: Smoking affects response to inhaled corticosteroids or leukotriene receptor antagonists in asthma. Am J Respir Crit Care Med. 2007, 175 (8): 783-90. 10.1164/rccm.200511-1746OC.CrossRefPubMedPubMedCentral
12.
Bouzigon E, Corda E, Aschard H, Dizier MH, Boland A, Bousquet J, Chateigner N, Gormand F, Just J, Moual Le, Scheinmann P, Siroux V, Vervloet D, Zelenika D, Pin I, Kauffmann F, Lathrop M, Demenais F: Effect of 17q21 variants and smoking exposure in early-onset asthma. N Engl J Med. 2008, 359 (19): 1985-94. 10.1056/NEJMoa0806604.CrossRefPubMed
13.
Polosa R, Knoke JD, Russo C, Piccillo G, Caponnetto P, Sarvà M, Proietti L, Al-Delaimy WK: Cigarette smoking is associated with a greater risk of incident asthma in allergic rhinitis. J Allergy Clin Immunol. 2008, 121 (6): 1428-34. 10.1016/j.jaci.2008.02.041.CrossRefPubMed
14.
Anderson HR: Increase in hospital admissions for childhood asthma: trends in referral, severity, and readmissions from 1970 to 1985 in a health region of the United Kingdom. Thorax. 1989, 44: 614-619. 10.1136/thx.44.8.614.CrossRefPubMedPubMedCentral
15.
Holgate ST, Polosa R: The mechanisms, diagnosis, and management of severe asthma in adults. Lancet. 2006, 368: 780-93. 10.1016/S0140-6736(06)69288-X.CrossRefPubMed
16.
global Initiative for Asthma (GINA): Global strategy for asthma management and prevention. NIH Publication 02-3659 issued January1995 (updated 2002); accessed at. [http://​www.​ginasthma.​org]
17.
Bateman ED, Hurd SS, Barnes PJ, Bousquet J, Drazen JM, FitzGerald M, Gibson P, Ohta K, O'Byrne P, Pedersen SE, Pizzichini E, Sullivan SD, Wenzel SE, Zar HJ: Global strategy for asthma management and prevention: GINA executive summary. Eur Respir J. 2008, 31 (1): 143-78. 10.1183/09031936.00138707.CrossRefPubMed
18.
19.
global Initiative for Asthma (GINA): Global strategy for asthma management and prevention (updated 2009). "Summary of Major Changes" page xii; accessed at. [http://​www.​ginasthma.​org]
20.
Polosa R, Al-Delaimy WK, Russo C, Piccillo G, Sarvà M: Greater risk of incident asthma cases in adults with allergic rhinitis and effect of allergen immunotherapy: a retrospective cohort study. Respir Res. 2005, 6: 153-10.1186/1465-9921-6-153.CrossRefPubMedPubMedCentral
21.
Dykewicz MS, Fineman S, Skoner DP, Nicklas R, Lee R, Blessing-Moore J, Li JT, Bernstein IL, Berger W, Spector S, Schuller D: Diagnosis and management of rhinitis: complete guidelines of the Joint Task Force on Practice Parameters in Allergy, Asthma and Immunology. American Academy of Allergy, Asthma, and Immunology. Ann Allergy Asthma Immunol. 1998, 81 (5 Pt 2): 478-518. 10.1016/S1081-1206(10)63155-9.CrossRefPubMed
22.
Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, November 1986. Am Rev Respir Dis. 1987, 136 (1): 225-44.
23.
Stewart AW, Asher MI, Clayton TO, Crane J, D'Souza W, Ellwood PE, Ford RP, Mitchell EA, Pattemore PK, Pearce N: The effect of season-of-response to ISAAC questions about asthma, rhinitis and eczema in children. Int J Epidemiol. 1997, 26 (1): 126-36. 10.1093/ije/26.1.126.CrossRefPubMed
24.
Althuis MD, Sexton M, Prybylski D: Cigarette smoking and asthma symptom severity among adult asthmatics. J Asthma. 1999, 36 (3): 257-64. 10.3109/02770909909075409.CrossRefPubMed
25.
Shavit O, Swern A, Dong Q, Newcomb K, Sazonov Kocevar V, Taylor SD: Impact of smoking on asthma symptoms, healthcare resource use, and quality of life outcomes in adults with persistent asthma. Qual Life Res. 2007, 16: 1555-65. 10.1007/s11136-007-9267-4.CrossRefPubMed
26.
Chalmers G, MacLeod K, Thomson L, Little S, McSharry C, Thomson N: Smoking and airway inflammation in patients with mild asthma. Chest. 2001, 120: 1917-1922. 10.1378/chest.120.6.1917.CrossRefPubMed
27.
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. 10.1378/chest.129.3.661.CrossRefPubMed
28.
Diaz-Sanchez D, Rumold R, Gong H: Challenge with environmental tobacco smoke exacerbates allergic airway disease in human beings. J Allergy Clin Immunol. 2006, 118 (2): 441-6. 10.1016/j.jaci.2006.04.047.CrossRefPubMed
29.
Thomson NC, Chaudhuri R, Livingston E: Asthma and cigarette smoking. Eur Respir J. 2004, 24 (5): 822-33. 10.1183/09031936.04.00039004.CrossRefPubMed
30.
Leuppi JD, Steurer-Stey C, Wildhaber J, Spertini F: Asthma control in Switzerland: a general practitioner based survey. Curr Med Res Opin. 2006, 22: 2159-66. 10.1185/030079906X148454.CrossRefPubMed
31.
Clatworthy J, Price D, Ryan D, Haughney J, Horne R: The value of self-report assessment of adherence, rhinitis and smoking in relation to asthma control. Primary Care Respiratory Journal. 2009, 18 (4): 300-5. 10.4104/pcrj.2009.00037.CrossRefPubMed
32.
Laforest L, Van Ganse E, Devouassoux G, Bousquet J, Chretin S, Bauguil G, Pacheco Y, Chamba G: Influence of patients' characteristics and disease management on asthma control. J Allergy Clin Immunol. 2006, 117: 1404-10. 10.1016/j.jaci.2006.03.007.CrossRefPubMed
33.
Schatz M, Zeiger RS, Vollmer WM, Mosen D, Cook EF: Determinants of future long-term asthma control. J Allergy Clin Immunol. 2006, 118: 1048-53. 10.1016/j.jaci.2006.07.057.CrossRefPubMed
34.
Cochrane GM, Horne R, Chanez P: Compliance in asthma. Respiratory Medicine. 1999, 93 (11): 763-9. 10.1016/S0954-6111(99)90260-3.CrossRefPubMed
35.
Blaiss MS: Inhaler technique and adherence to therapy. Curr Med Res Opin. 2007, 23 (Suppl 3): S13-20. 10.1185/030079907X226168. Part IICrossRefPubMed
36.
Adams RJ, Weiss ST, Fuhlbrigge A: How and by whom care is delivered influences anti-inflammatory use in asthma: results of a national population survey. J Allergy Clin Immunol. 2003, 112: 445-450. 10.1067/mai.2003.1625.CrossRefPubMed
37.
Tinkelman DG, Price DB, Nordyke RJ, Halbert RJ: Misdiagnosis of COPD and asthma in primary care patients 40 years of age and over. J Asthma. 2006, 43 (1): 75-80. 10.1080/02770900500448738.CrossRefPubMed
38.
Bernaards CM, Twisk JW, Snel J, Van Mechelen W, Kemper HC: Is calculating pack-years retrospectively a valid method to estimate life-time tobacco smoking? A comparison between prospectively calculated pack-years and retrospectively calculated pack-years. Addiction. 2001, 96 (11): 1653-61. 10.1046/j.1360-0443.2001.9611165311.x.CrossRefPubMed
39.
Tonnesen P, Pisinger C, Hvidberg S, Wennike P, Bremann L, Westin A, Thomsen C, Nilsson Fl: Effects of smoking cessation and reduction in asthmatics. Nicotine Tob Res. 2005, 7: 139-148. 10.1080/14622200412331328411.CrossRefPubMed
40.
Chaudhuri R, Livingston E, McMahon AD, Lafferty J, Fraser I, Spears M, McSharry CP, Thomson NC: Effects of smoking cessation on lung function and airway inflammation in smokers with asthma. Am J Respir Crit Care Med. 2006, 174: 127-133. 10.1164/rccm.200510-1589OC.CrossRefPubMed
41.
Piccillo G, Caponnetto P, Barton S, Russo C, Origlio A, Bonaccorsi A, Di Maria A, Oliveri C, Polosa R: Changes in airway hyperresponsiveness following smoking cessation: comparisons between Mch and AMP. Respir Med. 2008, 102 (2): 256-65. 10.1016/j.rmed.2007.09.004.CrossRefPubMed
Metadata
Title
Greater severity of new onset asthma in allergic subjects who smoke: a 10-year longitudinal study
Authors
Riccardo Polosa
Cristina Russo
Pasquale Caponnetto
Gaetano Bertino
Maria Sarvà
Tjana Antic
Stefania Mancuso
Wael K Al-Delaimy
Publication date
01-12-2011
Publisher
BioMed Central
Published in
Respiratory Research / Issue 1/2011
Electronic ISSN: 1465-993X
DOI
https://doi.org/10.1186/1465-9921-12-16

Other articles of this Issue 1/2011

Respiratory Research 1/2011 Go to the issue

Research

Simvastatin inhibits TGFβ1-induced fibronectin in human airway fibroblasts

Research

Expression analysis of asthma candidate genes during human and murine lung development

Review

TLR4 signalling in pulmonary stromal cells is critical for inflammation and immunity in the airways

Research

Lung glutathione adaptive responses to cigarette smoke exposure

Research

IFN-γ-inducible protein of 10 kDa upregulates the effector functions of eosinophils through β2integrin and CXCR3

Research

Tenascin-C and alpha-smooth muscle actin positive cells are increased in the large airways in patients with COPD
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

Read more

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine
Image Credits