Der Pneumologe

, Volume 9, Issue 3, pp 177–184

Epidemiologie und Bedeutung tabakassoziierter Lungenkrankheiten

Leitthema

Zusammenfassung

Für fast alle pneumologischen Erkrankungen besteht ein enger Zusammenhang mit dem Tabakrauchen. Dies wird durch die Vielzahl der im Tabakrauch enthaltenen irritativen, toxischen, mutagenen und karzinogenen Substanzen erklärt. Für die COPD und das Lungenkarzinom, zwei Krankheiten mit sehr hoher Prävalenz und Mortalität, ist Tabakrauch der mit Abstand wesentlichste Risikofaktor. Das Auftreten fast aller anderen Lungenkrankheiten wird durch das Rauchen vermehrt oder verschlimmert. Insbesondere sind hier Asthma, Influenza, Pneumonie, Tuberkulose, ARDS, pulmonale Hypertonie und interstitielle Lungenkrankheiten zu nennen. Auch Passivrauchen ist für COPD, Asthma, Lungenkarzinom, Pneumonie, Tuberkulose, ARDS und Berufserkrankungen mitverantwortlich zu machen. Ein umfassender Nichtraucherschutz bzw. ein niederschwelliger Zugang zur Tabakentwöhnung sind daher prioritäre Gesundheitsziele.

Schlüsselwörter

Rauchentwöhnung COPD Lungenkrebs Interstitielle Lungenerkrankungen Pulmonale Hypertonie 

Epidemiology and impact of tobacco-associated lung diseases

Abstract

Nearly all lung diseases are related to tobacco smoking. This can be explained by the multitude of irritative, toxic, mutagenic, and carcinogenic substances inhaled with cigarette smoke. For two diseases with high prevalence and mortality, i.e., chronic obstructive pulmonary disease (COPD) and lung cancer, cigarette smoke is the single main risk factor. However, nearly all other lung diseases are also caused or aggravated by smoking, e.g., asthma, influenza, pneumonia, tuberculosis, acute respiratory distress syndrome (ARDS), pulmonary hypertension, and interstitial lung disease. Furthermore, second-hand smoke is similarly related to COPD, asthma, lung cancer, pneumonia, tuberculosis, ARDS, and labor-related disease. Smoke-free legislation and uncomplicated access to smoking cessation services are, therefore, of high priority to the health system.

Keywords

Smoking cessation Chronic obstructive pulmonary disease Lung neoplasms Interstitial lung diseases Hypertension, pulmonary 

Literatur

  1. 1.
    Andreas S, Herth FJ, Rittmeyer A et al (2007) Tabakrauchen, chronisch obstruktive Lungenerkrankung und Lungenkarzinom. Pneumologie 61(9):590–594PubMedCrossRefGoogle Scholar
  2. 2.
    Rusanen M, Kivipelto M, Quesenberry CP Jr et al (2010) Heavy smoking in midlife and long-term risk of Alzheimer disease and vascular dementia. Arch Intern Med 171(4):333–339PubMedCrossRefGoogle Scholar
  3. 3.
    Andreas S, Batra A, Behr J et al (2008) Tabakentwöhnung bei COPD. S 3 Leitlinie herausgegeben von der Deutschen Gesellschaft für Pneumologie und Beatmungsmedizin. Pneumologie 62(5):255–272PubMedCrossRefGoogle Scholar
  4. 4.
    Doll R, Peto R, Boreham J et al (2004) Mortality in relation to smoking: 50 years‘ observations on male British doctors. BMJ 328(7455):1519PubMedCrossRefGoogle Scholar
  5. 5.
    Shahab L, Jarvis MJ, Britton J et al (2006) Prevalence, diagnosis and relation to tobacco dependence of chronic obstructive pulmonary disease in a nationally representative population sample. Thorax 61(12):1043–1047PubMedCrossRefGoogle Scholar
  6. 6.
    Vardavas CI, Anagnostopoulos N, Kougias M et al (2011) Acute pulmonary effects of using an e-cigarette: impact on respiratory flow resistance, impedance and exhaled nitric oxide. ChestGoogle Scholar
  7. 7.
    Raad D, Gaddam S, Schunemann HJ et al (2011) Effects of water-pipe smoking on lung function: a systematic review and meta-analysis. Chest 139(4):764–774PubMedCrossRefGoogle Scholar
  8. 8.
    Reid PT, Macleod J, Robertson JR (2010) Cannabis and the lung. 40(4):328–333Google Scholar
  9. 9.
    Andreas S, Anker SD, Scanlon PD et al (2005) Neurohumoral activation as a link to systemic manifestation of chronic lung disease. Chest 128:3618–3624PubMedCrossRefGoogle Scholar
  10. 10.
    Fletcher C, Peto R (1977) The natural history of chronic airflow obstruction. Br Med J 1(6077):1645–1648PubMedCrossRefGoogle Scholar
  11. 11.
    Anthonisen NR, Lindgren PG, Tashkin DP et al (2005) Bronchodilator response in the lung health study over 11 yrs. Eur Respir J 26(1):45–51PubMedCrossRefGoogle Scholar
  12. 12.
    Kohansal R, Martinez-Camblor P, Agusti A et al (2009) The natural history of chronic airflow obstruction revisited: an analysis of the Framingham offspring cohort. Am J Respir Crit Care Med 180(1):3–10PubMedCrossRefGoogle Scholar
  13. 13.
    Calverley PM, Rabe KF, Goehring UM et al (2009) Roflumilast in symptomatic chronic obstructive pulmonary disease: two randomised clinical trials. Lancet 374(9691):685–694PubMedCrossRefGoogle Scholar
  14. 14.
    Genuneit J, Weinmayr G, Radon K et al (2006) Smoking and the incidence of asthma during adolescence: results of a large cohort study in Germany. Thorax 61(7):572–578PubMedCrossRefGoogle Scholar
  15. 15.
    Thomson NC, Chaudhuri R, Livingston E (2004) Asthma and cigarette smoking. Eur Respir J 24(5):822–833PubMedCrossRefGoogle Scholar
  16. 16.
    Mackay D, Haw S, Ayres JG et al (2010) Smoke-free legislation and hospitalizations for childhood asthma. N Engl J Med 363(12):1139–1145PubMedCrossRefGoogle Scholar
  17. 17.
    Goeckenjan G, Sitter H, Thomas M et al (2010) Prävention, Diagnose, Therapie und Nachsorge des Lungenkarzinoms. Pneumologie 64(Suppl 2):e1–e164PubMedCrossRefGoogle Scholar
  18. 18.
    The Health Consequences of Smoking: A Report of the Surgeon General (2004) Atlanta, GA: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and HealthGoogle Scholar
  19. 19.
    Lee YJ, Cho BC, Jee SH et al (2009) Impact of environmental tobacco smoke on the incidence of mutations in epidermal growth factor receptor gene in never-smoker patients with non-small-cell lung cancer. J Clin Oncol 28(3):487–492PubMedCrossRefGoogle Scholar
  20. 20.
    Mills E, Eyawo O, Lockhart I et al (2011) Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med 124(2):144–154 e148PubMedCrossRefGoogle Scholar
  21. 21.
    Parsons A, Daley A, Begh R, Aveyard P (2010) Influence of smoking cessation after diagnosis of early stage lung cancer on prognosis: systematic review of observational studies with meta-analysis. BMJ 340:b5569PubMedCrossRefGoogle Scholar
  22. 22.
    Garces YI, Yang P, Parkinson J et al (2004) The relationship between cigarette smoking and quality of life after lung cancer diagnosis. Chest 126(6):1733–1741PubMedCrossRefGoogle Scholar
  23. 23.
    Murray RP, Connett JE, Zapawa LM (2009) Does nicotine replacement therapy cause cancer? Evidence from the Lung Health Study. Nicotine Tob Res 11(9):1076–1082PubMedCrossRefGoogle Scholar
  24. 24.
    Almirall J, Bolibar I, Balanzo X, Gonzalez CA (1999) Risk factors for community-acquired pneumonia in adults: a population-based case-control study. Eur Respir J 13(2):349–355PubMedCrossRefGoogle Scholar
  25. 25.
    Nuorti JP, Butler JC, Farley MM et al (2000) Cigarette smoking and invasive pneumococcal disease. Active bacterial core surveillance team. N Engl J Med 342(10):681–689PubMedCrossRefGoogle Scholar
  26. 26.
    Bates MN, Khalakdina A, Pai M et al (2007) Risk of tuberculosis from exposure to tobacco smoke: a systematic review and meta-analysis. Arch Intern Med 167(4):335–342PubMedCrossRefGoogle Scholar
  27. 27.
    Iribarren C, Jacobs DR Jr, Sidney S et al (2000) Cigarette smoking, alcohol consumption, and risk of ARDS: a 15-year cohort study in a managed care setting. Chest 117(1):163–168PubMedCrossRefGoogle Scholar
  28. 28.
    Calfee CS, Matthay MA, Eisner MD et al (2010) Active and passive cigarette smoking and acute lung injury after severe blunt trauma. Am J Respir Crit Care Med 183(12):1660–1665CrossRefGoogle Scholar
  29. 29.
    Antoniou KM, Hansell DM, Rubens MB et al (2008) Idiopathic pulmonary fibrosis: outcome in relation to smoking status. Am J Respir Crit Care Med 177(2):190–194PubMedCrossRefGoogle Scholar
  30. 30.
    Caminati A, Harari S (2006) Smoking-related interstitial pneumonias and pulmonary Langerhans cell histiocytosis. Proc Am Thorac Soc 3(4):299–306PubMedCrossRefGoogle Scholar
  31. 31.
    Kilburn KH, Warshaw RH (1994) Airways obstruction from asbestos exposure. Effects of asbestosis and smoking. Chest 106(4):1061–1070PubMedCrossRefGoogle Scholar
  32. 32.
    Wright JL, Levy RD, Churg A (2005) Pulmonary hypertension in chronic obstructive pulmonary disease: current theories of pathogenesis and their implications for treatment. Thorax 60(7):605–609PubMedCrossRefGoogle Scholar
  33. 33.
    Schiess R, Senn O, Fischler M et al (2010) Tobacco smoke: a risk factor for pulmonary arterial hypertension? A case-control study. Chest 138(5):1086–1092PubMedCrossRefGoogle Scholar
  34. 34.
    Knuiman M, James A, Divitini M, Bartholomew H (2006) Longitudinal study of risk factors for habitual snoring in a general adult population: the Busselton Health Study. Chest 130(6):1779–1783PubMedCrossRefGoogle Scholar
  35. 35.
    Falk GA, Briscoe WA (1970) Alpha-1-antitrypsin deficiency in chronic obstructive pulmonary disease. Ann Intern Med 72(3):427–429PubMedGoogle Scholar
  36. 36.
    Janson C, Künzli N, de Marco R at al (2006) Change in active and passive smoking in the EU respiratory health survey. Eur Respir J 27:517–524PubMedCrossRefGoogle Scholar
  37. 37.
    Bouzigon E, Corda E, Aschard H et al (2008) Effect of 17q21 variants and smoking exposure in early-onset asthma. N Engl J Med 359(19):1985–1994PubMedCrossRefGoogle Scholar
  38. 38.
    Eisner MD, Klein J, Hammond SK et al (2005) Directly measured second hand smoke exposure and asthma health outcomes. Thorax 60:814–821PubMedCrossRefGoogle Scholar
  39. 39.
    Becher H, Bertram B, Ehrmann K et al (2005) Deutsches Krebsforschungszentrum (Hrsg). Passivrauchen – ein unterschätztes Gesundheitsrisiko. HeidelbergGoogle Scholar
  40. 40.
    Altet MN, Alcaide J, Plans P et al (1996) Passive smoking and risk of pulmonary tuberculosis in children immediately following infection. A case-control study. Tuber Lung Dis 77(6):537–544PubMedCrossRefGoogle Scholar
  41. 41.
    Tong EK, England L, Glantz SA (2005) Changing conclusions on secondhand smoke in a sudden infant death syndrome review funded by the tobacco industry. Pediatrics 115(3): e356–e366PubMedCrossRefGoogle Scholar
  42. 42.
    Oberg M, Jaakkola MS, Woodward A et al (2011) Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet 377(9760):139–146PubMedCrossRefGoogle Scholar
  43. 43.
    Andreas S (2007) COPD: Ursachen – Zusammenhänge – Prävention. In: Ligner, Schultz (Hrsg), Volkskrankheit Asthma/COPD. Schwarz/Springer Medizin VerlagGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  1. 1.Lungenfachklinik Immenhausen, Kreis KasselPneumologische Lehrklinik Universität GöttingenImmenhausenDeutschland

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