Cigarette smoking is decresed in severe asthma and associated with chronic rhinosinusitis without nasal polyps

Although smoking habit has been related to bad control of asthma and associated to chronic rhinosinusitis (CRS) (Hastan 2011), data on harmful effects of tobacco smoke on asthma and upper airways diseases are still inconsistent. We sought to investigate the link between smoking and asthma severity and multimorbidities (rhinitis and CRS). In a multicenter cross-seccional study, asthma patients (N=492, 45±15yo, 70% female) were evaluated according to GINA (17.3% intermittent and 82.7% persistent -24.6% mild, 31.4% moderate, 26.7% severe-) and to ARIA/EPOS guidelines (49.6% had rhinitis- 37.0% allergic/AR, 12.6% non allergic/NAR -; 36.2% CRS -16.7% without/CRSsNP and 19.5% with/CRSwNP nasal polyps-, and 14.2% no sinonasal disease). Cigarette smoking was register by ananmnesis. Smoking prevalence was 9.6% (10.4% in women, 7.6% in men). According to asthma severity: 14% in intermittent and 8.6% in persistent ( mild 10.7%, moderate 11.7%, and severe 3.1%; p=0.025) asthma. According to sinonasal disease: 9.7% in NAR, 10.4% in AR, 11% in CRSsNP, 3% in CRSwNP, and 14.3% in those with no sinonasal disease (NS). Smokers were younger than non-smokers (38yo (28-49) vs. 46yo (34-58); p=0.09), had less severe asthma (8,5% vs. 28.5%; p=0.025) and lower prevalence of CRSwNP (6.4% vs. 20.9%; NS). Among severe asthmatics with CRS (N=66), there was a higher number of tobacco smokers in CRSsNP than in CRSwNP (10% vs. 0%, p=0.029). One out ten asthmatic patients were cigarette smokers. Smoking habit was decreased in severe asthma and in asthmatics with nasal polyps. However, smoking habit was increased in severe asthmatics with CRS without nasal polyps.