Original Articles: Asthma, Lower Airway DiseasesMulticenter study of cigarette smoking among patients presenting to the emergency department with acute asthma
Section snippets
INTRODUCTION
Cigarette smoking has profound deleterious effects on the respiratory system. It initiates microscopic changes at a cellular level with the apoptosis of alveolar cells and endothelial cell malfunction,1, 2 creating an environment that leads to macroscopic structural and functional destruction. Over time, these cumulative insults cause a progressive deterioration in pulmonary function.3, 4, 5, 6
The deterioration of pulmonary function is worse in patients with asthma who smoke. Longitudinal
METHODS
The National Emergency Department Safety Study was a patient safety study based in US EDs. Details of the study’s methods have been published previously.13 Our analysis used data from the study’s asthma medical record review component.
A total of 63 EDs participated, with most sites (n = 48) being academic EDs (ie, affiliated with an emergency medicine residency program). Patients were included in this study if they were between the ages of 14 and 54 years and had a principal ED or hospital
RESULTS
A total of 4,052 medical records of patients with acute asthma were reviewed, and 33% (95% CI, 31%–34%) were found to smoke cigarettes. The median age of the smokers was 34 years (IQR, 24–43 years); 64% were women, and 47% were black. Compared with nonsmokers, smokers were more likely to be older and male (Table 1). No statistically significant differences were found in race/ethnicity and medical history pertaining to asthma between both groups.
Nonsmokers were more likely to be prescribed
DISCUSSION
The prevalence of smoking among asthmatic patients who present to EDs in our sample was 33% (95% CI, 31%–34%), which is similar to the prevalence of 35% found by Silverman et al11 in 1996 to 1998. Although there has been a steady decrease in the rate of smoking in the US adult population during the past 10 years to 21%,19 there seems to be no change in prevalence of smoking among individuals with asthma who present to EDs. This persistently high prevalence of smoking among patients with asthma
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Cited by (21)
Multicenter study of cigarette smoking among adults with asthma exacerbations in the emergency department, 2011–2012
2017, Respiratory MedicineCitation Excerpt :Additionally, current and former smokers are more likely to need emergency care, with approximately 10% of emergency department (ED) visits for asthma exacerbations attributed to smoking [4]. Our previous studies through the late 1990s to early 2000s documented smoking rates between 33% and 35% in ED patients with asthma exacerbations [5,6]. Despite the clinical and public health importance of this topic, no recent multicenter efforts characterize this patient population.
Emergency Treatment and Approach to the Patient with Acute Asthma
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2013, Journal of Allergy and Clinical Immunology: In PracticeCitation Excerpt :Data abstraction was done with a standardized form and included patients' demographics, past asthma history, current asthma medications, patient presentation, PEF, treatment (in the ED or at discharge), and disposition. This standardized form was used in multiple US-based studies conducted by the Emergency Medicine Network.15-22 On the basis of common recommendations contained in the 2007 NIH asthma guidelines6 and using methods similar to those in the National Emergency Department Safety study with acute asthma,9 we derived a priori 8 explicit process measures, which included 5 level A and 3 level B evidence-based treatments (see Table E2 in this article's Online Repository at www.jaci-inpractice.org).
Environmental tobacco smoke exposure at home and smoking prevalence in the general Portuguese population - The INAsma study
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2012, Journal of Allergy and Clinical ImmunologyCitation Excerpt :However, we have conducted sensitivity analyses to address this issue, and the results did not materially change. In addition, the smoking rates in the NEDS asthma population were comparable with those from our previous multicenter study of adults with acute asthma.53 Second, the NEDS contains visit-level records and not patient-level records.
Disclosures: Dr Camargo has received financial support from a variety of groups for participation in conferences, consulting, and medical research. Recent industry sponsors with an interest in asthma were AstraZeneca, Critical Therapeutics, Dey, GSK, Merck, Novartis, Respironics, and Schering-Plough. The other authors have no declared conflicts of interest.
Funding Sources: The National Emergency Department Safety Study was supported by grant R01 HS-13099 from the Agency for Healthcare Research and Quality (Rockville, Maryland).