RETROSPECTIVE ANALYSIS OF IMPACT OF SMOKING ON THE TREATMENT RESPONSE TO INHALED CORTICOSTEROIDS AMONG PATIENTS WITH ASTHMA

Objective: Asthma is common found in both, the developed and the developing world. Among the patients presenting to the emergency medical care settings, patients with acute exacerbation of asthma occupy a significant percentage. This study hopes to assess the impact of smoking on treatment response to inhaled corticosteroids among patients with asthma. Methodology: This retrospective analysis was conducted upon a sample of 200 patients presenting at the department of general medicine and chest medicine at Liaquat University Hospital, Jamshoro with acute exacerbation of asthma (despite being on regular medication) from September 2017 to January 2018 after taking verbal informed consent. Inquiries were made regarding the habit of smoking, the treatment regimen and history of approaching an emergency healthcare setup due to acute exacerbation of asthma and mean hospital stay. In addition to the above, sputum samples were taken for investigating the sputum eosinophil level. Results: Among the study subjects, 70% of the sample comprised of males, while the remaining 30% were females. The mean age of the study population was 31 years, with 62% of the total subjects i.e. 124 patients admitting to be regular smokers (at least a cigarette per day). The mean frequency of emergency hospital visits were higher among smokers than non-smokers. The mean sputum eosinophil proportion among smokers was 0.6% while the mean sputum eosinophil proportion among non-smokers was 3.4%. Conclusion: After careful consideration, the obtained results show that the treatment response among non-smokers was markedly better than the treatment response observed in smokers. Thus asthma patients should be counselled against the use of cigarettes. Keywords: Smoking, Cigarette, Asthma, Eosinophilia, Sputum, Treatment Response.