Clinical Question: Is an increased ...

Clinical Question: Is an increased rate of infection another argument to encourage smoker to quit?

Setting: Outpatient (any)

cogitation Design: Systematic review

Synopsis: The authors of this systematic review searched MEDLINE for articles in succession the mechanisms and epidemiology of smoking-related infectious disease. Pneumococcal pneumonia is related to smoking, especially in patients with chronic obstructive pulmonary disease. In a population-based measure and estimate in Texas, smokers comprised 47 percent of the patients with invasive pneumococcal disease, although smoker typically comprise alone 23 percent of the population.

In brace case-control studies, adult smokers were sum of two units to four times more likely to bring to maturity invasive pneumococcal disease or pneumonia than similar nonsmoking adults (odd ratio [OR] in the brace studies = 1.9 to 41) Smoker are seven times more likely than nonsmokers to cause to grow legionnaires' disease (OR = 35; 95 percent confidence interval [CI], 33 to 17) Cigarette smoking also is associated with meningococcal disease. In common study of a meningococcal disease outbreak among association students, smokers were almost eight times more likely to become infected than nonsmokers, although the exact estimate is imprecise (OR = 78; 95 percent CI, 13 to 64)

aspect to secondhand smoke is associated, in a dose-related manner (the amount of smoking from the parents), with children developing meningococcal disease. Otitis media happens more frequently in children of smoking parents (OR = 19; 95 percent CI, 10 to 35) although the clinical course is similar between the couple groups. In another study, smoking during pregnancy predicted posterior ear infections in children in a dose-related fashion. Periodontal disease is 25 to six times more usual in smokers (again, in a dose-related manner) and is more hard Gastric and duodenal ulcers are more likely in smoker As is already well known, the customary cold, influenza, and tuberculosis come into one's head more often in smokers.

Bottom Line: The list of infections that meet the eye more commonly in smokers is protracted and not limited to the respiratory tract. chilleds pneumonia, tuberculosis, and influenza are more habitual in smokers, as is legionnaires' disease. Meningococcal disease, periodontal disease, and boils occur more frequently in smoker In children of parents who vanity especially mothers who smoke, otitis media present itselfs more frequently. All of these diagnoses ready another opportunity to counsel patients that their lives would be better without cigarettes. (Level of Evidence: 2b)

studious mood Reference: Arcavi L, Benowitz NL Cigarette smoking and infection. Arch Intern M November 8 2004;164:2206-16

Used with permission from Shaughnessy AF. Smoking increases risk of infection. Accessed online December 28 2004 at: http://www.InfoPOEMs.com.

COPYRIGHT 2005 American Academy of Family Physicians

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