Tobacco is a powerful trigger for bronchial asthma symptoms. Exposure to environmental tobacco smoke, be it active or passive, the advisory “smoking is injurious to health” holds true in all cases.
Lokesh, 65, has had bronchial asthma almost all his life. He recalls being 17 when he started smoking. The same year he was hospitalised because of breathlessness and cough. His reports revealed that he had severe bronchial asthma that aggravated owing to tobacco. When medicines did not help, the doctor suggested he opt for bronchial thermoplasty (BT).
Bronchial asthma is a chronic inflammatory disease of the airways that causes periodic attacks of wheezing, coughing, chest tightness and shortness of breath. When diagnosed with severe asthma, the patient's condition does not get better with usual medicines, and she needs specialist care and support.
According to reports by the World Health Organization, the tobacco epidemic is one of the biggest public health threats the world has ever faced, killing more than 8 million people a year. Of these, 7 million deaths are owing to direct tobacco use, while around 1.2 million are the result of non-smokers being exposed to secondhand smoke.
Tobacco is not healthy in any form. It is estimated that one person dies of tobacco-related disease every six seconds. Tobacco contains more than 200 harmful chemicals, including tar and nicotine that are carcinogenic and cause cancer of the mouth, throat, lung and bladder.
While we witness a surge in the number of smokers and thereby the number of severe asthma patients, the development of newer therapies like BT give hope of a better quality of life to patients. BT is a minimally invasive and non-drug procedure used to treat patients, who are 18 years or older, suffering from severe asthma. The procedure can only be carried on patients who are already on oral steroids for asthma exacerbations, ones who use inhalers more than twice a week and who have physical activity limitations because of asthma.
BT is carried out in three parts, scheduled three weeks apart. Each session is performed under moderate sedation and takes less than an hour to complete. BT procedure is not for patients who have an active implant device or known sensitivity to medications used in bronchoscopy. A thin catheter is introduced in the patient’s airway through a bronchoscope, and pushed to the end of the airway. It slowly heats up the area and contracts the expanded smooth muscles. This is withdrawn after every ten seconds from the airway. When the airways broaden, it becomes easy for the person to breathe, reducing asthma attacks.
Passive smokers get more affected as there is a lack of awareness. Secondhand smoke is one of the leading causes of asthma in non-smokers. Tobacco smoke inside a room stays in the air rather than dispersing, therefore people smoking indoors create a low-lying smoke cloud that is inhaled by others around them. Tobacco smoke contains around 7,000 chemicals, more than 70 of which are known to cause respiratory diseases and cancer. As mentioned by several leading health authorities, secondhand smoke is also a cause of lung cancer.
Smoking habit in pregnant ladies directly affects the baby, with the baby having more chances of developing bronchial asthma and smaller size lungs.
The need of the hour is to spread awareness among the masses to quit tobacco consumption in any form. A chest specialist can guide you regarding the management of withdrawal. For people who want to quit, chewing gums and skin patches can help decrease the craving to smoke. Oral medicines are available for patients who are unable to quit despite using gums and patches.
While exploring different ways to fight asthma, BT has helped bring down the dependence on steroids and multiple hospital visits. The technique does not promise to cure asthma, but has proven to reduce attacks. Despite introduction of improved medical interventions such as BT, quitting smoking remains the prime factor for adequate control.
Sharma is consultant, pulmonology, Metro Centre for Respiratory Diseases, Metro Hospital.