Interactions between Cigarette Smoking and the Natural History of Idiopathic Pulmonary Fibrosis: Discussion (Part 1)
Different findings emerge from the present study dealing with the interactions between cigarette smoking and the course of IPF. First, despite similar PFT results, nonsmokers had a shorter duration of symptoms at the time of presentation than smokers. Second, nonsmokers had higher alveolar lymphocyte counts than smokers. Third, the prednisolone therapy was more efficient in nonsmokers than in smokers. Finally, when males and females were compared, with respect to smoking habits, we did not demonstrate any gender difference. asthma inhalers
Cigarette Smoking Habit in IPF
In most of the reports concerning IPF, higher rates of smokers or exsmokers (60 to 80 percent) are observed than in the present study (40.7 percent).” This discrepancy may be related to different study populations and the exclusion of patients who had given up smoking habits between clinical onset and BAL procedure, but whatever its origin, this lower rate of smoking habits may explain in some way why we had the opportunity to compare two contrasted groups of patients.
Cigarette Smoking and Onset of IPF
The observation of shorter dyspnea duration at the time of presentation in the absence of smoking habits could reflect either true differences in disease duration or the unreliability of the clinical appraisal of such a subjective parameter. Indeed, it could reflect a recall bias affecting smokers and nonsmokers differently, ie, dyspnea could disturb earlier nonsmokers than smokers leading, in the absence of smoking habits, to early medical advice and prompt IPF recognition. Moreover the longer duration of dyspnea in the smokers may be due to the enhancement by smoking habits of preexisting diseases such as obstructive lung disease, apt to mask the clinical onset of IPF.