title: Impact of environmental tobacco smoke and active tobacco smoking on the development and outcomes of asthma and rhinitis.
abstract: OBJECTIVE
  We aim to discuss current insights on the influence of active smoking and environmental tobacco smoke in lower and upper respiratory inflammatory illnesses.
  
  
  RESULTS
  Insight has been gained on the effect of tobacco smoking on the development of asthma from the womb to adolescence. Secondhand tobacco exposure and active smoking play a major role not only in the inception of asthma epidemiological community studies but also in patients already suffering from allergic rhinitis. Tobacco seems to influence innate immunity predisposing to Th2-associated respiratory diseases and increasing the risk for IgE-mediated sensitization. Tobacco smoking is related to worst outcomes in both asthma and rhinitis.
  
  
  CONCLUSIONS
  Several deleterious effects have been described in asthma because of smoking: accelerated decline in lung function, more severe symptoms, impairment in quality of life and diminished therapeutic response to steroids. The harmful effect of tobacco smoking is not only on asthma but also on rhinitis playing a role in disease outcomes. Tobacco exposure can influence innate immunity diminishing innate production of antigen-presenting cells cytokines, as well as an impaired response to toll-like receptor ligands. Active smoking is associated with current symptoms of asthma and rhinitis and seems to be a risk factor for developing new asthma in patients with rhinitis. Tobacco smoking has been also found among the factors inducing nasal obstruction and decreased muco-ciliary clearance in nonallergic rhinitis.
authors.affiliation: Catholic University of Córdoba, Argentina. Cebaena.cagnani@worldallergy2009.com
authors.forename: Carlos E
authors.initials: CE
authors.lastname: Baena-Cagnani
authors.forename: R Maximiliano
authors.initials: RM
authors.lastname: Gómez
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Baena-Cagnani
authors.forename: G Walter
authors.initials: GW
authors.lastname: Canonica
mesh_terms: D001249:Asthma / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D007109:Immunity; D011247:Pregnancy; D011379:Prognosis; D012220:Rhinitis / Q000453:epidemiology / Q000503:physiopathology* / Q000517:prevention & control; D012307:Risk Factors; D012907:Smoking; D014028:Tobacco Smoke Pollution
chemical_list: D014028:Tobacco Smoke Pollution