This article is more than 5 years old. Information may no longer be current.

Cigarette smoking increased risk for severity in new-onset adult asthma

Patients with new-onset adult asthma and a history of smoking had an increased risk for asthma severity within 2 years of diagnosis, according to recent study results.

Researchers in Amsterdam studied 200 adults with new-onset asthma. A comprehensive assessment of clinical, functional and inflammatory parameters were conducted at baseline. Global Initiative for Asthma score, based on asthma control, lung function (FEV₁) and inhaled corticosteroid requirement, was used to measure the change in asthma severity after 2 years.

There were 128 patients (mean age, 48 years; 50.8% women) in the follow-up, and asthma severity increased in 17 patients (13.3%) and decreased in 53 others (41.4%).

“A lower postbronchodilator FEV₁/forced vital capacity ratio and a higher number of cigarette pack-years smoked at baseline were significantly associated with an increase in asthma severity at follow-up,” the researchers reported.

An independent association existed between every 10 pack-years of cigarettes smoked and an increase in asthma severity (OR=1.4; 95% CI, 1.02-1.91).

“We showed that smoking and having smoked in the past is an independent risk factor for increased asthma severity within 2 years after asthma diagnosis,” the researchers concluded. “The more pack-years smoked, the higher the risk of increased asthma severity. Lung function, sinus disease, and type of airway inflammation at the time of asthma diagnosis are not associated with more severe asthma after 2 years.

“These patients should be coached intensively to stop smoking and monitored closely and receive aggressive preventive therapy. Because inhaled corticosteroids are not very effective in these patients, novel targeted therapies need to be developed for this highly prevalent patient category.”

Disclosure: See the study for a full list of relevant financial disclosures.