From the Guidelines
Yes, you can develop asthma in adulthood as a smoker, and smoking cessation is crucial to improve asthma symptoms and overall lung health. Smoking is a significant risk factor for developing adult-onset asthma and can worsen existing asthma symptoms, as it irritates the airways, causing inflammation and increased mucus production, which narrows the breathing passages and makes breathing difficult 1. This chronic irritation can lead to permanent changes in lung function and trigger asthma development. According to a recent study, adult-onset asthma is associated with a poor treatment response and worse prognosis, and smoking is one of the most common risk factors for adult-onset asthma 1.
Key Points to Consider
- Smoking cessation is essential for improving asthma symptoms and overall lung health, as continuing to smoke reduces the effectiveness of asthma medications and accelerates lung function decline 1.
- Smokers who develop asthma may be prescribed standard asthma medications such as short-acting bronchodilators (like albuterol) for quick relief and inhaled corticosteroids (like fluticasone or budesonide) for long-term control.
- Quitting smoking can significantly improve asthma symptoms and overall lung health, though some damage may be permanent depending on smoking duration and intensity 1.
- The most recent study suggests that adult-onset asthma is a less quiescent disease than childhood-onset disease, with more relapses and fewer remissions, and it generally exhibits a poor treatment response and worse prognosis 1.
Recommendations for Management
- Smoking cessation should be encouraged as it is good for general health and may decrease asthma severity 1.
- Asthma medications such as short-acting bronchodilators and inhaled corticosteroids may be prescribed for smokers who develop asthma.
- Patients should be advised about the dangers of smoking and offered appropriate support to stop smoking 1.
From the Research
Asthma Development in Adulthood as a Smoker
- Asthma can develop in adulthood, and smoking is a significant risk factor for its development 2.
- Adult-onset asthma often differs from childhood-onset asthma, as it is often non-atopic, more severe, and associated with a faster decline in lung function 3.
- Smoking affects the response to inhaled corticosteroids or leukotriene receptor antagonists in asthma, making it more challenging to manage the condition 4.
- The presence of upper airway symptoms, including rhinitis, as well as lifestyle factors such as smoking, predicts those at greatest risk of developing adult-onset asthma 2.
- Reported wheeze, rhinitis, chronic cough, smoking, and lower levels of lung function are all predictors of asthma diagnosis in adulthood 2.
Risk Factors for Adult-Onset Asthma
- Smoking is a significant risk factor for adult-onset asthma, and smokers are more likely to experience symptoms and have a worse quality of life 4, 2.
- Upper airway symptoms, such as rhinitis, are also a risk factor for adult-onset asthma 2.
- Lifestyle factors, such as weight gain and excess decline in lung function, can also contribute to the development of adult-onset asthma 2.
Management of Adult-Onset Asthma
- Inhaled corticosteroids are the cornerstone of asthma therapy, but their effectiveness may be attenuated in smokers 4.
- Leukotriene receptor antagonists may be a viable alternative for managing asthma in smokers, as they have been shown to improve some outcomes in this population 4.
- Combination therapy with inhaled corticosteroids and a long-acting beta2-agonist may be effective for managing adult-onset asthma, but more research is needed to determine the best approach for smokers 5, 6.