J Korean Med Sci.  2009 Apr;24(2):209-214. 10.3346/jkms.2009.24.2.209.

The Impact of Smoking on Clinical and Therapeutic Effects in Asthmatics

• Jang AS
• Park JS
• Lee JH
• Park SW
• Kim DJ
• Uh ST
• Kim YH
• Park CS

• KMID: 1779120
• DOI: http://doi.org/10.3346/jkms.2009.24.2.209

Abstract

Smoking is associated with poor symptom control and impaired therapeutic responses in asthma. A total of 843 patients with asthma were recruited. The patients received treatment for 1 yr according to the severity of their asthma. We compared the forced expiratory volume in 1 sec (FEV1), the ratio of FEV1 to forced vital capaity (FVC), atopy, total IgE, emphysema on high-resolution computed tomography (HRCT), the number of near-fatal asthma attacks, and physiological fixed airway obstruction between the smoking and nonsmoking groups. The study population consisted of 159 (18.8%) current smokers, 157 (18.7%) ex-smokers, and 525 (62.5%) nonsmokers. Although the prevalence of atopy was not different between the smoking and nonsmoking groups, the total IgE was higher among the smokers than the nonsmokers. Compared with the nonsmoking group, the smokers had a lower FEV1 % predicted and forced expiratory flow between 25 and 75% of FVC. A greater prevalence of emphysema and a significantly higher number of asthmatic patients with fixed airway obstruction were detected in the smoking versus nonsmoking group. The 37.5% of asthmatic patients who were former or current smokers showed decreased pulmonary function and increased IgE, emphysema on HRCT, and fixed airway obstruction, indicating that smoking can modulate the clinical and therapeutic responses in asthma.

Keyword

Smoking; Asthma; Atopy; Immunoglobulin E; Remodeling

MeSH Terms

Airway Obstruction/etiology
Asthma/complications/*diagnosis/*drug therapy
Female
Forced Expiratory Volume/physiology
Humans
Immunoglobulin E/analysis
Male
Middle Aged
Pulmonary Emphysema/etiology/radiography
Respiratory Function Tests
Respiratory Insufficiency/etiology
Smoking/*adverse effects
Tomography, X-Ray Computed