Asthma and smoking
Data from the WHO statistical studies confirm that the number of smokers in the world exceeds one billion people. Approximately 25% of smokers are exposed to asthma - one of the most common smoking-related diseases.
Smoking is one of the main asthma triggers. The inhalation of cigarette smoke significantly increases the risk of this respiratory disease even in those patients, who do not have a genetic predisposition to it.
Asthmatic smokers have an increased sensitivity to respiratory allergens, including dust, sharp smells or cigarette smoke. This can cause severe allergies and/or increase the risk of asthma exacerbation.
The likelihood of recurrence of this respiratory tract disease, or an increase in its symptoms frequency is significantly increased in smokers:
- whose asthma began in childhood or adolescence;
- who started smoking at an early age or smoke more than five cigarettes a day.
With regular inhalation of tobacco smoke, the function of the respiratory tract worsens progressively in asthmatic smokers. For example, the lungs function in asthmatics, who smoke more than 15 cigarettes a day, can decrease by approximately 20% in ten years.
The inhalation of cigarette smoke irritates the mucous membranes of the respiratory organs, which causes an increase in sputum production. This mucus clogs smaller airways, which can cause a bronchial asthma attack.
Active asthmatic smokers with impaired respiratory function suffer from significantly increased frequency and intensity of such asthma symptoms, as severe coughing, asphyxia, and acute bronchial spasms.
Some asthmatics may have severe wheezing, asphyxia, plentiful sputum or chest tightness within a few hours after a smoked cigarette.
In addition to nicotine, cigarettes contain various toxic substances that enter the body when smoke is inhaled. These toxins accumulate in the respiratory tract and in the lungs, contributing to a gradual:
- Reduction in the airway walls elasticity;
- Increase in sensitivity to other asthma triggers;
- Reduction of the volume of air inhaled in one second;
- Irritation or inflammation of the mucous membranes of the respiratory tract.
These disorders contribute to a significant risk increase in the recurrence of respiratory disease in asthmatic smokers. In addition, cigarette smoke harms not only the active smokers, but people that surround him, as well.
Secondhand smoking is just as common asthma trigger, as the active smoking is. For this reason, asthmatics are not recommended to spend time in smoky rooms or near people, who smoke.
Data of statistical studies prove that the risk of asthma in children, whose parents smoke more than 10 cigarettes a day, is about 3 times higher, than that of children in non-smoking families.
The likelihood of asthma relapse significantly increases in children, who are exposed to secondhand smoke. For this reason, smoking parents should refrain from smoking at home or in the presence of children.
Smoking cigarettes during pregnancy is one of the main risk factors for asthma in children after birth. To let the fetus develop properly, pregnant women are not recommended to:
- Consume tobacco products
- Be exposed to secondhand smoke
- Be in smoke-filled premises
Active smokers have a significantly increased resistance to inhaled corticosteroids, which are the strongest anti-asthmatic drugs. Thus, smoking can reduce the effectiveness of asthma treatment.
Smoking increases the synthesis of certain enzymes that accelerate the metabolism and the removal of anti-asthmatic drugs from the body. Thus, inhaling cigarette smoke reduces the therapeutic effect of inhaled corticosteroids.
To increase the efficacy of drugs for anti-asthma treatment, smokers are additionally prescribed:
- Uniphyl or other medicines with Theophylline.
- Antioxidant Acetylcysteine (available under the name Mucomyst).
The use of these medicines helps increase the asthmatic smokers' clinical response to inhaled corticosteroids, and thus improve the effectiveness of treatment for severe or moderate asthma.
To reduce the risk of asthma exacerbation, asthmatic smokers need to attend educational programs on asthma management, and regularly go through a complete assessment of the respiratory system.
To improve the efficacy of asthma treatment or to prevent its relapse, patients are recommended to completely give up smoking. For the treatment of nicotine dependence, asthmatics are prescribed a combined therapy that includes such methods, as:
- behavior modification
- nicotine replacement therapy
- psychological counseling
Quitting smoking contributes to a gradual restoration of the respiratory system function, as well as a reduction in the risk of respiratory tract infections and a reduction of sputum production.
Asthma symptoms may worsen for about a week after patient quits smoking. However, strong cough, wheezing with breathing or asphyxia gradually decrease with prolonged abstinence from smoking.
In addition, the efficacy of bronchodilators and/or corticosteroids significantly increases in asthmatics who quit smoking. As of now, these are the most effective drugs for the treatment or prevention of asthma.
In cases where the patient can not quit smoking, he can be prescribed combined medicines for asthma treatment, including Advair (Fluticasone and Salmeterol), Dulera (Mometasone and Formoterol) or Symbicort (Budesonide and Formoterol).
These anti-asthmatic drugs contribute to a rapid reduction in inflammation of the respiratory tract and reduce sputum production. Their use helps reduce the frequency and/or intensity of asthma attacks.
In addition, these combined drugs for the treatment of asthma contribute to a fast relief of asthma exacerbation, caused by a sudden smoking cessation.