Impact of cigarette smoking on symptoms and quality of life of adults with asthma managed in public primary care clinics in Singapore: a questionnaire study

• Published in: Primary care respiratory journal Vol. 21; no. 1; pp. 90 - 93
• Main Authors: Tan, Ngiap Chuan, Ngoh, Soh Heng Agnes, Teo, Stephanie Swee Hong, Swah, Teck Sin, Chen, Zhaojin, Tai, Bee Choo
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.03.2012
• Subjects: Adult; Asthma - physiopathology; Cough - physiopathology; Female; Humans; Male; Middle Aged; Primary Health Care - statistics & numerical data; Quality of Life; Research Paper; Respiratory Sounds - physiopathology; Singapore; Smoking - adverse effects; Surveys and Questionnaires; Singapore
• ISSN: 1471-4418; 1475-1534
• DOI: 10.4104/pcrj.2012.00003

Cigarette smoking aggravates asthma exacerbations, yet some patients with asthma continue to smoke. To compare the quality of life of adult smokers and non-smokers with asthma. Asthma Quality of Life (AQLQ) questionnaires were administered to adult patients with asthma managed in primary care in Singapore. The survey also included data of their asthma status including symptom profiles. Independent two-sample t-test, ANCOVA model, χ2 test and ordinal logistic regression were used to compare the mean domain scores and the effect of smoking on nocturnal symptoms and awakening, respectively. 357 adult asthma patients (183 non-smokers and 174 smokers) were recruited. Smokers were mainly male (p<0.001), single (p=0.008), and younger (mean age 30 years) (p=0.007). They were more affected by nocturnal cough and wheezing (p=0.016). After adjustment for age, gender, and asthma medications, the mean scores of the AQLQ 'symptoms' and 'emotional function' domains of smokers were 0.41 (95% CI 0.10 to 0.72) and 0.50 (95% CI 0.16 to 0.84) points lower than for non-smokers, with no statistical differences in the 'activity limitations' and 'exposure to environmental stimuli' domains. Adult patients with asthma who smoke are more affected by nocturnal symptoms, with lower 'emotional function' scores in the AQLQ.