Projects per year
Importance: The negative association of smoking with the respiratory tract is well known; however, the association between smoking and chronic rhinosinusitis (CRS) has not been well characterized. Objective: To analyze whether active smoking was a risk factor for CRS development, smoking was associated with disease-specific quality of life, and smokers experience an increased symptom burden than nonsmokers.
Design, Setting, and Participants: This subanalysis of the Chronic Rhinosinusitis Epidemiology Study (CRES), a prospective, questionnaire-based case-control study conducted between October 2007 and September 2013 was conducted across 30 UK tertiary/secondary care sites. Participants were identified at ear, nose, and throat outpatient clinics and classified into CRS phenotypes as per European Position Paper on Rhinosinusitis and Nasal Polyps 2012 criteria. The overall response rate of those identified to take part in the study was 66%. A total of 1535 questionnaires were returned, with 1470 considered eligible for inclusion. Data analysis was conducted in January 2020.
Main Outcomes and Measures: The CRES was designed to distinguish differences in socioeconomic status, geography, medical comorbidities, lifestyle, and quality of life between patients with CRS and healthy controls.
Results: A total of 1450 patients completed the smoking question, comprising 219 controls (15.1%; mean [SD] age, 47.3 [14.9] years; 143 women [68%]), 546 participants with CRS (37.7%; mean [SD] age, 51.8 [15.3] years; 259 women [53%]) without nasal polyps (CRSsNPs), and 685 participants (47.2%; mean [SD] age, 56.0 [14.5] years; 204 women [33%]) with CRS and nasal polyps/allergic fungal rhinosinusitis (CRSwNPs+). The mean age was similar, with a greater female preponderance in the control group and male in the CRSwNP group. The greatest number of active smokers was found among control participants (33 [15%]), with a lower rate of smokers in the patients with CRSwNPs+ (9.9%) and CRSsNPs (13.9%), respectively. We found a clinically significant difference in the mean difference in Sino-nasal Outcome Test (SNOT-22) scores between active smokers and nonsmokers for both CRS phenotypes (4.49, 12.25). In both CRS subgroups active smokers had significantly worse SNOT-22 scores than nonsmokers by a mean (SD) magnitude of 10 (18.99, 24.14) points. Nonsmokers also demonstrated a higher percentage of surgical procedures (1 or more), although this was not clinically or statistically different (0.34, 1.10).
Conclusions and Relevance: This questionnaire-based case-control study demonstrated a clinically significant symptom burden associated with active cigarette smoking, with worse SNOT-22 scores in the smoking cohort by a mean magnitude of 10 points. We could find no demonstrable evidence that smoking increases the likelihood of need for revision sinus surgery. Clinicians should encourage smoking cessation alongside general CRS medical management.
|Number of pages||7|
|Early online date||10 Dec 2020|
|Publication status||Published - Feb 2021|
- chronic rhinosinusitis
- quality of life
- Norwich Medical School - Associate Professor
- Epidemiology and Public Health - Member
- Health Services and Primary Care - Member
- Norwich Clinical Trials Unit - Member
- Public Health and Health Services Research - Member
Person: Research Group Member, Academic, Teaching & Research
- Norwich Medical School - Professor of Rhinology & Olfactology
- Respiratory and Airways Group - Member
Person: Academic, Teaching & Scholarship, Research Group Member
- 1 Finished
Clinical Senior Lectureship - Clinical Research Ear, Nose and Throat
Fraser, W., Harvey, I. & Philpott, C.
James Paget University Hospitals NHS Foundation Trust
1/01/10 → 31/03/20
- 10 Citations (Scopus)
- 7 Article
Exploring the association between ingestion of foods with higher potential salicylate content and symptom exacerbation in chronic rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology StudyPhilpott, C., Smith, R., Davies-Husband, C., Erskine, S., Clark, A., Welch, A., Hopkins, C., Carrie, S., Ray, J., Sunkaraneni, V., Kara, N., Kumar, N., Robertson, A., Anari, S., Almeyda, R., Wilson, A. & CRES group, Jun 2019, In: Rhinology. 57, 4, p. 303-312 10 p.
Research output: Contribution to journal › Article › peer-reviewOpen AccessFile7 Citations (Scopus)16 Downloads (Pure)
Current use of baseline medical treatment in chronic rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology Study (CRES)Philpott, C., Erskine, S., Smith, R., Hopkins, C., Kara, N., Farboud, A., Salam, M., Robertson, A., Almeyda, R., Kumar, B. N., Anari, S., Ray, J., Cathcart, R., Carrie, S., Ahmed, S., Khalil, H., Clark, A. & Thomas, M., Apr 2018, In: Clinical Otolaryngology. 43, 2, p. 509–524 16 p.
Research output: Contribution to journal › Article › peer-reviewOpen AccessFile15 Citations (Scopus)12 Downloads (Pure)
Chronic rhinosinusitis and mood disturbanceErskine, S. E., Hopkins, C., Clark, A., Anari, S., Robertson, A., Sunkaraneni, S., Wilson, J. A., Beezhold, J. & Philpott, C. M., 1 Jun 2017, In: Rhinology. 55, 2, p. 113-119 7 p.
Research output: Contribution to journal › Article › peer-reviewOpen AccessFile37 Citations (Scopus)15 Downloads (Pure)