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Smoking and asthma: dangerous liaisons

Riccardo Polosa, Neil C. Thomson
European Respiratory Journal 2013 41: 716-726; DOI: 10.1183/09031936.00073312
Riccardo Polosa
*Institute of Internal Medicine and Clinical Immunology, AOU “Policlinico-Vittorio Emanuele”, Università di Catania, Catania, Italy
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  • For correspondence: polosa@unict.it
Neil C. Thomson
#Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK
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Abstract

Cigarette smoking and asthma interact to induce important adverse effects on clinical, prognostic and therapeutic outcomes. This review examines recent evidence on the harmful effects of smoking in asthma, possible underlying inflammatory mechanisms for this altered response, management options for these patients and potential future therapeutic directions. Active smokers, particularly females, are at risk of developing asthma. Prevalence rates for smoking in asthma are relatively close to those found in the general population. Smokers with asthma experience worse asthma control than nonsmokers with asthma. Mechanisms for the adverse effects of smoking in asthma include altered airway inflammation and corticosteroid insensitivity. Quitting smoking can improve symptoms and lung function, but the low rates of smoking cessation highlights the need for improved strategies for managing these patients. Clinical trials assessing new therapies for asthma need to enrol smokers to identify treatments that are effective in the asthma smoking phenotype.

  • Asthma
  • smoking
  • smoking cessation

Footnotes

  • Support Statement

    R. Polosa's research on smoking and asthma is currently supported by LIAF (Lega Italiana AntiFumo; Catania, Italy).

  • Statement of Interest

    Statements of interest for R. Polosa and N.C. Thomson can be found at www.erj.ersjournals.com/site/misc/statements.xhtml

  • Received May 8, 2012.
  • Accepted July 26, 2012.
  • ©ERS 2013
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European Respiratory Journal: 41 (3)
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Smoking and asthma: dangerous liaisons
Riccardo Polosa, Neil C. Thomson
European Respiratory Journal Mar 2013, 41 (3) 716-726; DOI: 10.1183/09031936.00073312

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Smoking and asthma: dangerous liaisons
Riccardo Polosa, Neil C. Thomson
European Respiratory Journal Mar 2013, 41 (3) 716-726; DOI: 10.1183/09031936.00073312
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  • Article
    • Abstract
    • SMOKING AS A RISK FACTOR FOR THE DEVELOPMENT OF ASTHMA
    • CLINICAL OUTCOMES IN SMOKERS WITH ASTHMA
    • EFFECTS OF SMOKING ON LUNG FUNCTION
    • SMOKING AND REDUCED CORTICOSTEROID SENSITIVITY
    • MECHANISMS FOR THE ADVERSE CONSEQUENCES OF SMOKING IN ASTHMA
    • ASTHMA AND SMOKING CESSATION
    • CURRENT PHARMACOLOGICAL TREATMENTS
    • FUTURE THERAPIES FOR SMOKERS WITH ASTHMA
    • CONCLUSIONS AND FUTURE DIRECTIONS
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  • Asthma and allergy
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