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Question answered:28/04/06 Warning! this question is over two years old.
Using Trip and Medline, we were unable to find evidence about the effect of reducing / stopping smoking or of nicotine replacement therapy on chest infections. Both Prodigy guidance on chest infections (1) and SIGN guidance on “Community Management of Lower Respiratory Tract Infection in Adults” (2) suggest “the presentation of a smoker with a chest infection is an ideal opportunity to introduce smoking cessation measures.” Neither mentions any effect on outcome.
In the Prodigy guidance on smoking cessation (3), it makes no reference to its value in relation to chest infections, but says:
“Smoking is associated with more severe symptoms or prolonged disease in asthma, the common cold, influenza, pneumonia, tuberculosis, chronic rhinitis, diabetic retinopathy, hyperthyroidism, multiple sclerosis, optic neuritis, and Crohn's disease.”
We found a review on Medline that seems to promise useful information, but as we have been unable to view the full text we cannot verify their findings. The abstract says:
“Cigarette smoking …is associated with differences in the incidence, severity, or natural history of a broad array of other respiratory illnesses, ranging from the common cold to pneumothorax, pulmonary hemorrhage, and various interstitial lung diseases.
In this article, the author briefly discusses some of the pulmonary and systemic effects of smoking that might mediate its effects on an array of lung diseases, then comprehensively reviews less common or less well-recognized smoking-affected lung diseases such as pulmonary infections, spontaneous pneumothorax, Goodpasture's syndrome, eosinophilic granuloma and other interstitial lung diseases, and pulmonary metastatic disease.”
References
1. PRODIGY. “Chest infections”, last revised July 05.
(http://www.prodigy.nhs.uk/ProdigyKnowledge/Guidance/WholeGuidanceView.aspx?GuidanceId=37307)
2. SIGN guideline 59, “Community Management of Lower Respiratory Tract Infection in Adults”, June 02.
(http://www.sign.ac.uk/pdf/sign59.pdf)
3. PRODIGY. “Smoking cessation”, last revised Feb 06.
(http://www.prodigy.nhs.uk/ProdigyKnowledge/Guidance/WholeGuidanceView.aspx?GuidanceId=56293)
4. Murin, S. et al. “Other smoking-affected pulmonary diseases.” Clinics in chest medicine, March 00, 21 (1), pgs 121 -137.
(http://www.hubmed.org/search.cgi?q=murin+pulmonary&sort=date)
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