Consensus document on asthma and smoking of the Regional Asthma Forum of SEPAR/Documento de consenso sobre asma y tabaquismo del Foro Autonomico de Asma de la SEPAR

• Published in: Adicciones (Palma de Mallorca) Vol. 35; no. 1; p. 67
• Main Authors: Romero-Palacios, Pedro Jose, Alvarez-Gutierrez, Francisco J, Signes-Costa, Jaime, Blanco-Aparicio, Marina, Soto-Campos, Jose G, Jimenez-Ruiz, Carlos A, Callejas-Gonzalez, Francisco J, Riesco-Miranda, Juan A, Garcia-Rivero, Juan L, Pastor-Espla, Esther
• Format: Journal Article
• Language: English
• Published: Socidrogalcohol 01.03.2023
• ISSN: 0214-4840

The prevalence of active smoking in adults with asthma is similar in the total population. Smoking is associated with worse clinical control of the disease, a rapid reduction of lung function and a variable response to corticoids. Tobacco consumption negatively affects the quality of life of asthmatic patients as well as increasing the number of medical visits and hospital admissions due to exacerbations. Moreover, smoking entails a higher risk of developing lung cancer, cardiovascular comorbidities and death in asthmatic patients. Nevertheless, current asthma guidelines do not include specific recommendations on the management of smoking asthmatic patients and the treatment of the smoking habit in this subpopulation. For this reason, a narrative review of the literature was carried out for consensus using a nominal group methodology developed throughout 2019 to extract practical recommendations that would allow the diagnosis and treatment of asthma in smokers, as well as the treatment of smoking in asthmatics, to be improved. The conclusions and recommendations were validated at the SEPAR national congress of the same year. Among the most relevant, the need to address smoking in people with asthma through health advice, pharmacological treatment and behavioral therapy was emphasized, as this is a factor that negatively impacts the symptoms, prognosis and response to asthma treatment. In smokers with suspected asthma, the presence of emphysema and the differential diagnosis of other diseases should be evaluated and the impact of smoking on the result of diagnostic tests should be considered. It is also concluded that smoking reduces the response to treatment with inhaled corticosteroids, which is why combined therapy with bronchodilators is recommended. Keywords: Asthma; smoking; treatment; consensus; recommendations. La prevalencia de tabaquismo activo en adultos con asma es similar a la de la poblacion general. El tabaquismo se asocia con un peor control clinico de la enfermedad, una disminucion acelerada de la funcion pulmonar y una respuesta irregular a la terapia con glucocorticoides. El consumo de tabaco impacta negativamente en la calidad de vida de los pacientes asmaticos y provoca un incremento en el numero de visitas y de hospitalizaciones por exacerbaciones. Ademas, el tabaquismo aumenta el riesgo de cancer de pulmon, comorbilidades cardiovasculares y muerte en pacientes asmaticos. A pesar de todo ello, las guias actuales del manejo del asma no incluyen recomendaciones especificas para el manejo de los pacientes asmaticos fumadores. Por este motivo, se procedio a una revision narrativa de la literatura para un consenso mediante metodologia de grupo nominal desarrollada a lo largo del ano 2019 para extraer recomendaciones practicas que permitieran mejorar el diagnostico y el tratamiento del asma en fumadores, asi como el tratamiento del tabaquismo en asmaticos. Las conclusiones y recomendaciones fueron validadas en el congreso nacional de la SEPAR del mismo ano. Entre las mas relevantes, se incidio en la necesidad de abordar el tabaquismo en las personas con asma mediante consejo sanitario, tratamiento farmacologico y terapia conductual, al ser un factor que impacta negativamente en la sintomatologia, el pronostico y la respuesta al tratamiento del asma. En el fumador con sospecha de asma, se debe evaluar la presencia de enfisema y el diagnostico diferencial de otras enfermedades y considerar el impacto del tabaquismo en el resultado de las pruebas diagnosticas. Tambien se concluye que el habito tabaquico reduce la respuesta al tratamiento con corticoides inhalados, por lo que se recomienda terapia combinada con broncodilatadores. Palabras clave: Asma; tabaquismo; tratamiento; consenso; recomendaciones.