D2.374 - Smoking increases mortality risk of chronic inflammatory airway diseases: a real-world hospital cohort study

Previous studies have linked asthma to increased mortality, but data on inflammatory upper airway diseases and smoking-related mortality remain limited. We aimed to assess mortality rates in asthma, allergic rhinitis (AR), chronic rhinosinusitis with (CRSwNP) or without nasal polyps (CRSsNP), and NSAID-exacerbated respiratory disease (N-ERD), hypothesizing that smoking elevates mortality risk in these conditions.

This retrospective cohort study included 74,868 patients visiting a tertiary hospital in Helsinki, Finland, between 2004–2011. Data of diagnoses and smoking status were obtained from electronic health records. Mortality and causes of death were obtained from Statistics Finland, with follow-up extending to death or censoring on 31.12.2021. Propensity score matching was used to match smokers with controls. 

Smoking significantly increased all-cause mortality risk (p < 0.001) among all subjects and subgroups with asthma, AR, CRSwNP, CRSsNP, and/or N-ERD. When both smokers and non-smokers were considered, asthma, AR, CRSwNP, CRSsNP, and/or N-ERD alone were not associated with increased mortality compared to controls in Cox´s regression models matched for age and gender.

Smoking is strongly linked to increased mortality in patients with inflammatory upper and lower airway diseases. These findings highlight the importance of smoking cessation interventions in this population.