Niedoszytko Marek, Gruchała-Niedoszytko Marta, Chełminska Marta, Sieminska Alicja, Jassem Ewa
Department of Allergology, Medical University of Gdansk, Gdansk, Poland.
J Asthma. 2008 Aug;45(6):495-9. doi: 10.1080/02770900802074810.
In the present study we assessed the impact of former cigarette smoking on asthma control and treatment effectiveness.
A total of 104 patients with uncontrolled asthma were included in the study. The group of former smokers consisted of 33 subjects, whereas the never smokers group consisted of 71 subjects of similar age and gender. Spirometry, classification of asthma severity, and control were assessed according to Global Initiative for Asthma (GINA) guidelines. Quality of life was measured with the use of the Saint George Hospital Respiratory Questionnaire (SGHRQ).
Asthma was more severe in the group of former smokers both before and after treatment; p < 0.001. Severe asthma (OR 7.8 CI 2.8-21.9) and cigarette smoking (OR 3.5 CI 1.3-9.2) were associated with difficulties in asthma control achievement. Total quality of life significantly improved in the group of non-smokers; p = 0.02, whereas in former smokers this effect was not significant; p > 0.05.
Cigarette smoking has a persistent, dose-dependent, negative impact on the response to treatment in patients with uncontrolled asthma even after smoking cessation. Smoking cessation should remain the ultimate goal in treatment of asthmatic patients. More efforts should be undertaken to decrease smoking initiation, especially in teenagers.
在本研究中，我们评估了既往吸烟对哮喘控制及治疗效果的影响。
本研究共纳入104例哮喘控制不佳的患者。既往吸烟者组由33名受试者组成，而从不吸烟者组由71名年龄和性别相似的受试者组成。根据全球哮喘防治创议（GINA）指南评估肺功能、哮喘严重程度分级及控制情况。使用圣乔治医院呼吸问卷（SGHRQ）测量生活质量。
既往吸烟者组治疗前后哮喘均更严重；p<0.001。重度哮喘（比值比7.8，可信区间2.8 - 21.9）及吸烟（比值比3.5，可信区间1.3 - 9.2）与实现哮喘控制困难相关。非吸烟者组的总体生活质量显著改善；p = 0.02，而既往吸烟者组这一效果不显著；p>0.05。
即使戒烟后，吸烟对哮喘控制不佳患者的治疗反应仍有持续的、剂量依赖性的负面影响。戒烟应始终是哮喘患者治疗的最终目标。应做出更多努力以减少开始吸烟的情况，尤其是在青少年中。
