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Cigarette smoking and infection.
Arch Intern Med. 2004 Nov 08; 164(20):2206-16.AI

Abstract

BACKGROUND

Infectious diseases may rival cancer, heart disease, and chronic lung disease as sources of morbidity and mortality from smoking. We reviewed mechanisms by which smoking increases the risk of infection and the epidemiology of smoking-related infection, and delineated implications of this increased risk of infection among cigarette smokers.

METHODS

The MEDLINE database was searched for articles on the mechanisms and epidemiology of smoking-related infectious diseases. English-language articles and selected cross-references were included.

RESULTS

Mechanisms by which smoking increases the risk of infections include structural changes in the respiratory tract and a decrease in immune response. Cigarette smoking is a substantial risk factor for important bacterial and viral infections. For example, smokers incur a 2- to 4-fold increased risk of invasive pneumococcal disease. Influenza risk is severalfold higher and is much more severe in smokers than nonsmokers. Perhaps the greatest public health impact of smoking on infection is the increased risk of tuberculosis, a particular problem in underdeveloped countries where smoking rates are increasing rapidly.

CONCLUSIONS

The clinical implications of our findings include emphasizing the importance of smoking cessation as part of the therapeutic plan for people with serious infectious diseases or periodontitis, and individuals who have positive results of tuberculin skin tests. Controlling exposure to secondhand cigarette smoke in children is important to reduce the risks of meningococcal disease and otitis media, and in adults to reduce the risk of influenza and meningococcal disease. Other recommendations include pneumococcal and influenza vaccine in all smokers and acyclovir treatment for varicella in smokers.

Authors+Show Affiliations

Clinical Pharmacology Unit, Kaplan Medical Center, Rehovot, Israel.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.
Review

Language

eng

PubMed ID

15534156

Citation

Arcavi, Lidia, and Neal L. Benowitz. "Cigarette Smoking and Infection." Archives of Internal Medicine, vol. 164, no. 20, 2004, pp. 2206-16.
Arcavi L, Benowitz NL. Cigarette smoking and infection. Arch Intern Med. 2004;164(20):2206-16.
Arcavi, L., & Benowitz, N. L. (2004). Cigarette smoking and infection. Archives of Internal Medicine, 164(20), 2206-16.
Arcavi L, Benowitz NL. Cigarette Smoking and Infection. Arch Intern Med. 2004 Nov 8;164(20):2206-16. PubMed PMID: 15534156.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cigarette smoking and infection. AU - Arcavi,Lidia, AU - Benowitz,Neal L, PY - 2004/11/10/pubmed PY - 2004/12/16/medline PY - 2004/11/10/entrez SP - 2206 EP - 16 JF - Archives of internal medicine JO - Arch Intern Med VL - 164 IS - 20 N2 - BACKGROUND: Infectious diseases may rival cancer, heart disease, and chronic lung disease as sources of morbidity and mortality from smoking. We reviewed mechanisms by which smoking increases the risk of infection and the epidemiology of smoking-related infection, and delineated implications of this increased risk of infection among cigarette smokers. METHODS: The MEDLINE database was searched for articles on the mechanisms and epidemiology of smoking-related infectious diseases. English-language articles and selected cross-references were included. RESULTS: Mechanisms by which smoking increases the risk of infections include structural changes in the respiratory tract and a decrease in immune response. Cigarette smoking is a substantial risk factor for important bacterial and viral infections. For example, smokers incur a 2- to 4-fold increased risk of invasive pneumococcal disease. Influenza risk is severalfold higher and is much more severe in smokers than nonsmokers. Perhaps the greatest public health impact of smoking on infection is the increased risk of tuberculosis, a particular problem in underdeveloped countries where smoking rates are increasing rapidly. CONCLUSIONS: The clinical implications of our findings include emphasizing the importance of smoking cessation as part of the therapeutic plan for people with serious infectious diseases or periodontitis, and individuals who have positive results of tuberculin skin tests. Controlling exposure to secondhand cigarette smoke in children is important to reduce the risks of meningococcal disease and otitis media, and in adults to reduce the risk of influenza and meningococcal disease. Other recommendations include pneumococcal and influenza vaccine in all smokers and acyclovir treatment for varicella in smokers. SN - 0003-9926 UR - https://www.unboundmedicine.com/medline/citation/15534156/full_citation L2 - https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/archinte.164.20.2206 DB - PRIME DP - Unbound Medicine ER -