Smoke in the air affects the nose and sinuses

The new study, published in the Archives of Otolaryngology and Head and Neck Surgery, included 306 nonsmokers with chronic rhinosinusitis and 306 nonsmokers who had many of the same characteristics but did not have rhinosinusitis. The participants provided information about their secondhand smoke exposure in four settings: home, work, public places, and private social functions.

More than 47% of people without rhinosinusitis and 68% of people with rhinosinusitis reported regular secondhand smoke exposure. Compared with people without chronic rhinosinusitis, those with the condition were more likely to experience regular secondhand smoke exposure in each of the four settings. Smoke exposure at work was most strongly associated with chronic rhinosinusitis.

Eliminating smoke could eliminate a common problem

Chronic rhinosinusitis affects up to 16% of the US population and is associated with over 13 million physician visits per year. People with chronic rhinosinusitis suffer from a range of symptoms including nasal congestion, chronic cough, throat clearing, hoarseness, difficulty with breathing at night in bed, lack of sleep, lack of energy, fatigue, malaise, headache, facial pressure, loss of sense of smell and taste, bad breath, sore throats, and recurrent infections. Allergies and anatomical abnormalities are frequent causes of rhinosinusitis, but in a number of cases no cause is found.

“The results from our study suggest that many chronic rhinosinusitis cases are due to or are aggravated by secondhand smoke exposure,” said lead study author Dr. C. Martin Tammemagi at Brock University in Ontario, Canada. “We estimate that, if secondhand smoke could be eliminated, the incidence of chronic rhinosinusitis would be reduced by approximately 40%.”

The many dangers of secondhand smoke

Many people are not aware of how hazardous secondhand smoke is:

• It contains more than 4,000 chemicals.
• 69 known carcinogens have been identified in secondhand smoke, including some polynuclear aromatic hydrocarbons, which are highly carcinogenic.
• The concentrations of some carcinogens are higher in sidestream smoke (the smoke that goes directly into the air) than in mainstream smoke (the smoke that is inhaled).
• The US Environmental Protection Agency has classified sidestream smoke as a clearly established human carcinogen, responsible for approximately 3,000 lung cancer deaths every year in the US.
• It has been estimated that 62,000 deaths from heart disease each year are attributable to secondhand smoke exposure.
• Secondhand smoke exposure is the third leading cause of preventable death in the US.
• In addition to lung cancer and heart disease, secondhand smoke has been found to increase the risks of brain, breast, pancreatic, and renal cancers; premature birth, low birth weight, and sudden infant death syndrome; cognitive impairment and dementia; and respiratory infections, allergies, asthma, and now chronic rhinosinusitis.

(Arch Otolaryngol Head Neck Surg 2010;136:327–34)