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Smoking as a Modifying Factor in Chronic Rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology Study

21 Pages Posted: 25 Jun 2020

See all articles by Kristian Hutson

Kristian Hutson

James Paget University Hospital NHS Foundation Trust

Allan Clark

Norwich Medical School, University of East Anglia

Claire Hopkins

Guys & St Thomas Hospital NHS Foundation Trust

Shahzada Ahmed

University Hospitals Birmingham NHS Foundation Trust

Nirmal Kumar

Wrightington Wigan and Leigh NHS Foundation Trust

Sean Carrie

Freeman Hospital

Sally Erskine

James Paget University Hospital NHS Foundation Trust

San Sunkaraneni

Royal Surrey County Hospital

Carl Philpott

Newcastle Upon Tyne Hospitals NHS Foundation Trust; University of East Anglia (UEA) - Rhinology & ENT Research Group

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Abstract

Background: The deleterious impact of smoking on the respiratory tract is well known, however the relationship between smoking and chronic rhinosinusitis (CRS) has not been well characterised.

Methods: Sub-analysis of the Chronic Rhinosinusitis Epidemiology Study (CRES), a prospective, questionnaire-based case-control study. We sought to analyse whether smoking was a risk factor for CRS and whether it has an impact on disease specific quality of life.

Findings: A total of 1450 patients completed the CRES smoking question, resulting in data for 219 controls, 546 CRS participants without nasal polyps (CRSsNP) and 685 participants with CRS and nasal polyps (CRSwNPs+). The greatest number of smokers was found amongst control participants (15%) with lower rate of smokers in both CRSwNPs+ participants (9.9%) and CRSsNPs patients (13.9%) respectively (p=0.03, Chi-squared test). We found a significant difference in the mean difference in SNOT-22 scores between smokers and non-smokers for both CRS phenotypes (p<0.001) on Analysis of Variance. In both CRSsNPs and CRSwNPs+ groups, smokers had significantly worse SNOT-22 scores than non-smokers by a mean magnitude of 10 points. This remained significant after adjusting for age and sex, asthma and SF-36 scores (p = 0.001 and 0.02). Non smokers also demonstrated a higher percentage of surgical procedures (one or more) although this was not statistically different (p=0.098).

Interpretation: We could find no association between current smoking status and prevalence of disease; however, smoking does have a significant impact upon disease specific patient quality of life.

Funding: The study was sponsored by the University of East Anglia (UEA) and funded by the Anthony Long and Bernice Bibby Trusts.

Declaration of Interests: None.

Ethics Approval Statement: Ethical approval was granted by the Oxford C Research Ethics Committee (Ref: 07/H0606/100)

Keywords: Rhinosinusitis; smoking; quality of life

Suggested Citation

Hutson, Kristian and Clark, Allan and Hopkins, Claire and Ahmed, Shahzada and Kumar, Nirmal and Carrie, Sean and Erskine, Sally and Sunkaraneni, Vishnu and Philpott, Carl, Smoking as a Modifying Factor in Chronic Rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology Study (3/28/2020). Available at SSRN: https://ssrn.com/abstract=3566255 or http://dx.doi.org/10.2139/ssrn.3566255

Kristian Hutson

James Paget University Hospital NHS Foundation Trust ( email )

Allan Clark

Norwich Medical School, University of East Anglia

Claire Hopkins

Guys & St Thomas Hospital NHS Foundation Trust

Shahzada Ahmed

University Hospitals Birmingham NHS Foundation Trust

Nirmal Kumar

Wrightington Wigan and Leigh NHS Foundation Trust

Sean Carrie

Freeman Hospital

Sally Erskine

James Paget University Hospital NHS Foundation Trust

Vishnu Sunkaraneni

Royal Surrey County Hospital ( email )

Egerton Rd
Guildford GU2 7XX
United Kingdom

Carl Philpott (Contact Author)

Newcastle Upon Tyne Hospitals NHS Foundation Trust ( email )

Newcastle
United Kingdom

University of East Anglia (UEA) - Rhinology & ENT Research Group ( email )