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Published ahead of print on April 27, 2006, doi:10.1164/rccm.200510-1589OC

Am. J. Respir. Crit. Care Med., Volume 174, Number 2, July 2006, 127-133

A more recent version of this article appeared on July 15, 2006
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Submitted on October 11, 2005
Accepted on April 27, 2006

Effects of Smoking Cessation on Lung Function and Airway Inflammation In Smokers with Asthma

Rekha Chaudhuri1, Eric Livingston1, Alex D McMahon2, Jane Lafferty1, Iona Fraser3, Mark Spears1, Charles P McSharry3, and Neil C Thomson1*

1 Department of Respiratory Medicine, University of Glasgow, Glasgow, United Kingdom, 2 Robertson Centre for Biostatistics, University of Glasgow, Glasgow, United Kingdom, 3 Department of Immunology, University of Glasgow, Glasgow, United Kingdom

* To whom correspondence should be addressed. E-mail: n.c.thomson{at}clinmed.gla.ac.uk.

Rationale: Active smoking in asthma is associated with worsening of symptoms, accelerated decline in lung function and impaired response to corticosteroids. Objectives: To examine the short-term effects of smoking cessation on lung function, airway inflammation and corticosteroid responsiveness in smokers with asthma. Methods and measurements: Smokers with asthma were given the option to quit or continue smoking. Both groups underwent spirometry and induced sputum at baseline and at one, three and six weeks. Cutaneous vasoconstrictor response to topical beclometasone, airway response to oral prednisolone and sensitivity of peripheral blood lymphocytes to corticosteroids were measured before smoking cessation and at six weeks. Main results: Of 32 subjects recruited, 11 opted to continue smoking (smoking controls). Twenty-one subjects opted for smoking cessation of whom ten quit smoking for six weeks (quit group). Comparing quitters with controls at six weeks, the mean (Cl) difference in FEV1 was 407 ml (21,793), p=0.040; and the proportion of sputum neutrophils reduced by -29 (-51, -8), p=0.039. Total cutaneous vasoconstrictor response score to topical beclometasone improved following smoking cessation with a mean (CI) difference of 3.56 (0.84, 6.28), p=0.042 comparing quitters with control smokers. There was no change in airway corticosteroid responses after smoking cessation. Conclusions: Six weeks after smoking cessation, smokers with asthma achieved considerable improvement in lung function and a fall in sputum neutrophil count compared to smokers who continued to smoke. These findings highlight the importance of smoking cessation in asthma.
Key words: Smoking cessation: smoking: asthma; lung function




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