Tobacco smoke is involved in uncontrolled asthma, a diminished response to anti-asthma drugs, rhinitis, nasal obstruction, and deregulation of the immune system according to an international expert at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in Miami Beach, Fla.
Tobacco smoking has been mainly associated with chronic obstructive pulmonary disease (COPD), and is attributed to being one of the main reasons that COPD disease is the fourth leading cause of death in the United States.
"Recent studies have shown that smoking can be linked with other respiratory diseases such as asthma exacerbations and rhinitis," said Carlos Baena-Cagnani, M.D., faculty of medicine, at Catholic University of Cordoba in Argentina. "Both active and passive smoking has been shown to be involved in uncontrolled asthma and associated with asthma exacerbations in children and adolescents."
According to Dr. Baena-Cagnani, active smoking also causes changes in inflammation in asthma patients, diminishes their response to anti-asthma drugs, and has been found to induce nasal obstruction and decreased mucociliary clearance.
"The message is that smoking is a risk factor for the inception of asthma in allergic rhinitis patients, and it should be discouraged in patients with rhinitis," he said. "There is increasing and compelling evidence that respiratory diseases, such as asthma and COPD, are also related to a deregulation of the immune system, especially the innate (natural) immunity."
According to the latest World Health Organization statistics, currently 300 million people have asthma, and 210 million people have COPD, while millions have allergic rhinitis and other often under-diagnosed chronic respiratory diseases, Dr. Baena-Cagnani said.
"The impact of tobacco smoking is huge, with over one billion people exposed to unhealthy air in which tobacco smoking plays a major role," he said.
Current statistics show that approximately 20 percent of U.S. adults are smokers, and more than half of them have the desire to quit according to a "Smoking Cessation Toolbox for Allergists" recently published in Annals of Allergy, Asthma & Immunology, ACAAI's scientific journal. Surveys indicate that a physician's advice to quit is an important motivator to quit smoking. "Screening, providing brief counseling, and prescribing first-line smoking cessation medications will help the United States get closer to achieving the national goal laid out in Healthy People 2010 of smoking rates of 12 percent or less" the investigators report.
"Allergists are aware of the significant impact that tobacco addiction has on our patients, and we are committed to initiating and reinforcing smoking cessation as part of our treatment plan," said Richard G. Gower, M.D., an allergist/immunologist at Marycliff Allergy Specialists in Spokane, Wash., and president of ACAAI.
"We play an important role in advocating for children exposed to harmful second-hand smoke. Removing smoking as an impact factor, especially for asthma patients, improves their response to therapy and results in healthier patients."
An allergist, an expert in the diagnosis and treatment of allergies and asthma, can perform allergy testing to identify the specific substances that trigger allergic reactions and determine the most appropriate and effective treatment.
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