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 Active Smoking and Asthma: A Volatile Mix
"All by itself, smoking is destructive and often deadly. In someone with asthma, smoking seems unfathomable, but they are addicted. People with asthma who smoke need everyone's help and support to quit using tobacco."
-Kirsten Jensen
Asthma Policy and Programs Manager
American Lung Association of Oregon
Pathophysiology
Asthma is a disease characterized by ongoing inflammation of the airways, an overproduction of mucus, and airway constriction due to tightened muscles.These conditions are thought to contribute to permanent structural changes in the lungs, called airway remodeling. In turn, these changes usually lead to accelerated declines in lung function, including irreversible decreases in airflow due to narrowed air passages.
Smoking has been shown to directly damage the defense mechanisms of the respiratory tract by reducing the ability of the cilia to clear the respiratory tract, and by altering bronchial mucus production. In addition, an inflammatory process of the small airways develops in smokers, and in susceptible individuals, this process becomes progressive and causes airway narrowing.
Through these mechanisms, smoking frequently causes chronic bronchitis and emphysema. Bronchitis is characterized by excessive mucus secretion and chronic or recurrent cough. Emphysema results when the alveoli, or air sacs, of the lung lose their elasticity. Normal airflow in and out of the lung becomes obstructed and lung function is compromised. Armed with this information, you may assume that people with asthma avoid smoking. This is a reasonable, albeit incorrect, assumption. Although smoking is a known trigger for asthma, many asthmatics smoke. This publication takes a peek at Oregon data on this incongruous phenomenon.
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