Division of Respiratory Diseases, IRCCS San Matteo Hospital Foundation, University of Pavia, Pavia, Italy.
Int Arch Allergy Immunol. 2012;158(2):175-83. doi: 10.1159/000330900. Epub 2012 Jan 26.
The prevalence rates of smoking in subjects with asthma have frequently been reported as similar to those in the general population; however, available data are not up-to-date. There is only limited and somewhat conflicting information on the long-term effects of smoking on health outcomes among population-based cohorts of subjects with asthma. We aimed to investigate changes in smoking habits and their effects on forced expiratory volume in 1 s (FEV(1)) in subjects with asthma in comparison with the rest of the population, focusing on the healthy smoker effect.
We studied 9,092 subjects without asthma and 1,045 with asthma at baseline who participated in both the European Community Respiratory Health Survey I (20-44 years old in 1991-1993) and II (1999-2002).
At follow-up, smoking was significantly less frequent among subjects with asthma than in the rest of the population (26 vs. 31%; p < 0.001). Subjects with asthma who were already ex-smokers at the beginning of the follow-up in the 1990 s had the highest mean asthma score (number of reported asthma-like symptoms, range 0-5), probably as a result of the healthy smoker effect (2.80 vs. 2.44 in never smokers, 2.19 in quitters and 2.24 in smokers; p < 0.001). The influence of smoking on FEV(1) decline did not depend on asthma status. Smokers had the highest proportion of subjects with chronic cough/phlegm (p < 0.01).
One out of 4 subjects with asthma continues smoking and reports significantly more chronic cough and phlegm than never smokers and ex-smokers. This stresses the importance of smoking cessation in all patients with asthma, even in those with less severe asthma.
哮喘患者的吸烟率常被报道与普通人群相似，但现有数据已过时。基于人群的哮喘患者队列中，关于吸烟对健康结果的长期影响的信息有限且存在一定冲突。我们旨在研究哮喘患者吸烟习惯的变化及其对 1 秒用力呼气量（FEV1）的影响，并与普通人群进行比较，重点关注健康吸烟者效应。
我们研究了在基线时既无哮喘又有哮喘的 9092 名和 1045 名参与者，他们均参加了欧洲社区呼吸健康调查 I（1991-1993 年时年龄为 20-44 岁）和 II（1999-2002 年）。
随访时，哮喘患者的吸烟率明显低于普通人群（26%比 31%；p<0.001）。在 20 世纪 90 年代随访开始时已戒烟的哮喘患者的哮喘评分最高（报告的哮喘样症状数，范围 0-5），可能是由于健康吸烟者效应（从不吸烟者为 2.80，戒烟者为 2.19，吸烟者为 2.24；p<0.001）。吸烟对 FEV1 下降的影响与哮喘状态无关。吸烟者中慢性咳嗽/咳痰的比例最高（p<0.01）。
每 4 名哮喘患者中就有 1 名继续吸烟，报告的慢性咳嗽和咳痰明显多于从不吸烟者和戒烟者。这强调了在所有哮喘患者中戒烟的重要性，即使是那些哮喘程度较轻的患者。
