Lung function changes in patients with chronic obstructive pulmonary disease (COPD) and asthma exposed to secondhand smoke in outdoor areas

Abstract

Background

Further evidence is needed on the effects that short- and long-term exposure to secondhand smoke (SHS) have on the respiratory health of patients with lung disease. Within the TackSHS project we aimed to assess the acute respiratory effects in lung function that result from short-term SHS exposure among patients with asthma and chronic obstructive pulmonary disease (COPD).

Methods

The study design was an intervention trial with measurements before/after exposure to SHS in legal outdoor smoking areas. We studied patients with asthma or COPD from Czechia, Ireland, and Spain. Forced spirometry, peak flow and carbon monoxide (CO) measurements were performed pre- and 24 h post- exposure.

Results

Overall, 60 patients were studied, 30 with asthma, and 30 with COPD; 35 (58.3%) were female. There were no significant differences observed in exhaled CO between pre- and 24 h post-exposure neither in women (p = 0.210), nor in men (p = 0.169).

A statistically significant decrease in forced vital capacity (FVC) was seen, overall, in asthma participants (p = 0.02) and in forced expiratory volume in the first second (FEV₁), (p = 0.02), FVC (p = 0.04) and peak expiratory flow rate (PEFR) (p = 0.04) in female asthmatic participants. The observed decreases in respiratory measurements in COPD were not significant. There were no reported increases in symptoms, respiratory medication, or use of health services 24 h after the exposure.

Conclusion

We conclude that acute, short-term SHS exposure had a statistically significant effect on spirometry in female asthma patients but did not significantly modify spirometric indices 24 h later in COPD patients.

Keywords:

• Asthma
• COPD
• e-cigarettes
• outdoor areas
• secondhand smoke
• smoking

Additional information

Funding

This project has received funding from the European Union's Horizon 2020 research and innovation programme under grant agreement No 681040. BA received the support of a fellowship from “La Caixa” Foundation (ID 100010434; Fellowship code: LCF/BQ/IN17/11620013). AL was supported by a fellowship from the Italian Association for Cancer Research (AIRC). The Tobacco Control Research Group at ICO-IDIBELL (BA, EF, MF) is partly supported by the Ministry of Universities and Research, Government of Catalonia (2017SGR319). EF is partly supported by the Instituto de Salud Carlos III, Government of Spain, co-funded by the European Regional Development Fund (FEDER; INT16/00211 and INT17/00103). The work of SG was partially funded by the Italian League Against Cancer (LILT, Milan). SS was funded from GRant 167 from RCDHT.