Effects of Smoking Cessation on Lung Function and Airway Inflammation in Smokers with Asthma

University of Glasgow, Glasgow, Scotland, United Kingdom
American Journal of Respiratory and Critical Care Medicine (Impact Factor: 13). 08/2006; 174(2):127-33. DOI: 10.1164/rccm.200510-1589OC
Source: PubMed


Active smoking in asthma is associated with worsening of symptoms, accelerated decline in lung function, and impaired response to corticosteroids.
To examine the short-term effects of smoking cessation on lung function, airway inflammation, and corticosteroid responsiveness in smokers with asthma.
Smokers with asthma were given the option to quit or continue smoking. Both groups underwent spirometry and induced sputum at baseline and at 1, 3, and 6 wk. Cutaneous vasoconstrictor response to topical beclometasone, airway response to oral prednisolone, and sensitivity of peripheral blood lymphocytes to corticosteroids were measured before smoking cessation and at 6 wk.
Of 32 subjects recruited, 11 opted to continue smoking (smoking control group). Of 21 subjects who opted for smoking cessation, 10 quit smoking for 6 wk (quit group). In the comparison of quitters with smokers at 6 wk, the mean (confidence interval [CI]) difference in FEV(1) was 407 ml (21, 793), p = 0.040, and the proportion of sputum neutrophils was reduced by 29 (51, 8), p = 0.039. Total cutaneous vasoconstrictor response score to topical beclometasone improved after smoking cessation with a mean (CI) difference of 3.56 (0.84, 6.28), p = 0.042, between quitters and smokers. There was no change in airway corticosteroid responses after smoking cessation.
By 6 wk after smoking cessation, subjects who quit smoking had achieved considerable improvement in lung function and a fall in sputum neutrophil count compared with subjects who continued to smoke. These findings highlight the importance of smoking cessation in asthma.

Download full-text


Available from: Mark Spears, Dec 17, 2014
  • Source
    • "Dias-Júnior (2014) 84 33 patients with severe asthma and obesity (mean BMI 39 kg/m 2 , mean age 42 years old) 6-month randomized open-labelled controlled trial, weight loss program (low caloric intake, sibutramine 10 mg per day, and orlistat maximum 120 mg per day) versus standard care There were significant reduction in body weight (7.5%) and also improvements in asthma control and FVC. Chaudhuri (2006) 85 32 smokers with asthma (mean age 47 years old, 36 pack-year) 6-week, non-randomized open controlled trial, smoking cessation There were significant improvement in FEV1 and reduction in sputum neutrophils. Tønnesen (2005) 86 220 smokers with asthma (mean age 35 years old, 19 pack-year) 4-month, randomized open controlled trial, complete smoking cessation versus smoking reduction to fewer than seven cigarettes/day versus continuation of usual smoking "
    [Show abstract] [Hide abstract]
    ABSTRACT: Recent literature has emphasized the clinical and socio-epidemiological significance of asthma in the elderly. However, why the disease burden remains high in this group is unclear. Elderly subjects usually have multiple chronic illnesses, and the role played by comorbidities in the context of asthma has been underappreciated. This review aims to summarize the literature associations between comorbidities and asthma in elderly patients. In addition, we discuss patient management issues. © The Korean Academy of Asthma, Allergy and Clinical Immunology.
    Full-text · Article · Sep 2015 · Allergy, asthma & immunology research
  • Source
    • "Smoking in young adults slows the rate of lung growth, and causes early and rapid deterioration of lung function (GOLD, 2011). Smoking cessation at any age holds promise of slowing down the decline in lung functions and improves respiratory symptoms (Chaudhuri et al, 2006; Bohadana et al, 2006). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Background: Tobacco smoking is a risk factor for chronic respiratory disorders. Tobacco epidemic is driven by adolescents and young adults. Tobacco-related morbidity rises with increasing years of smoking and increasing number of young smokers may have considerable future public health implications. Objective: This study investigated the effect of tobacco smoking on pulmonary function indices among undergraduates. Method: Cross sectional study involving 104 male undergraduates, between 18 and 30 years. They were recruited by snowball sampling and grouped based on their smoking status (current smoker 52: non-smoker 52). Participants with signs of respiratory disease or thoracic spine deformity or contraindication to spirometry were excluded from the study. Participants’ forced vital capacity (FVC), forced expiratory volume in first second (FEV1) both in litres and forced expiratory ratio (FER) in percentage were assessed using standard protocols. Data were analyzed using mean, standard deviation, independent t-test and chi-square test with alpha level set at 0.05. Results: The two groups were not significantly different in age, height and body mass index. Smokers had significantly reduced FVC (3.42±0.42 vs 3.87±0.4 litres) p=0.03; FEV1 (2.39±0.37 vs 3.22±0.38 litres) p=0.001 and FER (%) (70.7±7.58vs82.3±4.05) p=0.01. Among the smokers a relationship was observed between years and numbers of cigarette smoked and lung function. Proportion of participants with FER below the age-matched reference was significantly higher among smokers than non-smokers (40.4%vs6.7%) at p=0.021. Conclusion: Smoking reduced pulmonary function among undergraduates. This may have important public health implications as continued smoking may accelerate lung function deterioration and consequently increase future risk of developing lung disease.
    Full-text · Article · Nov 2014
  • Source
    • "Several studies reported that cigarette smoking adversely affects the immune system, particularly lymphocyte development, and strongly correlates with inflammation markers.20,21 However, smoking cessation restores the immune levels to normal and lowers airway inflammation, and the degree of improvement is better when using the anti-inflammatory treatment.20,22 Extrapolating from our results, smoking cessation could decrease the inflammation, protect humans from the development of infections and, overall, may strengthen immunity. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective The risks of cigarette smoking concerning higher systemic disease mortality are lessened by smoking cessation. Methods Microarray analysis compared the expression profiles of smokers who were successful and not successful at smoking cessation, with the goal of identifying genes that might serve as potential biomarkers or that might be valuable in elucidating distinct biological mechanisms. The mRNAs were isolated and compared from peripheral leukocytes of six smokers who were successful in cessation and six smokers who failed in smoking cessation. Results Two hundred ninety nine genes displayed significantly different expression; 196 genes were up-regulated and 103 genes were down-regulated in the success group compared to the failure group. Twenty four of these genes were identified with biological processes including immunity, cytoskeleton and cell growth/cycle. Real-time PCR confirmed the differential gene expression. The mRNA levels of HEPACAM family member 2 (HEPACAM2) and tropomodulin 1 (TMOD1) were significantly more expressed in the success group, while the mRNA ubiquitin specific peptides 18 (USP18) were significantly less expressed in the success group compared to the failure group. Conclusion The results suggest that smoking cessation can modulate cell adhesion and immune response by regulating expression levels of genes, especially HEPACAM2, TMOD1 and USP18, which have an important relationship with smoking cessation.
    Full-text · Article · Jul 2014 · Psychiatry investigation
Show more