Documento de consenso sobre asma y tabaquismo del Foro Autonómico de Asma de la SEPAR

Autores/as

  • Francisco Javier Álvarez-Gutiérrez Unidad de Asma. Unidad Médico-Quirúrgica de Enfermedades Respiratorias. Hospital Universitario Virgen del Rocío, Sevilla.
  • Marina Blanco-Aparicio Servicio de Neumología, Complejo Hospitalario Universitario A Coruña.
  • Jaime Signes-Costa Miñana Servicio de Neumología, Hospital Clínico Universitario de Valencia.
  • Esther Pastor-Esplá Servicio de Neumología, Hospital Universitario San Juan De Alicante.
  • Juan Luis García-Rivero Servicio de Neumología, Hospital Comarcal de Laredo, Cantabria.
  • José Gregorio Soto-Campos UGC de Neumología y Alergia, Hospital de Jerez, Jerez de la Frontera.
  • Francisco Javier Callejas-González Servicio de Neumología, Complejo Hospitalario Universitario de Albacete.
  • Pedró José Romero-Palacios Universidad de Granada.
  • Juan Antonio Riesco-Miranda Unidad de Tabaquismo del Complejo Hospitalario Universitario de Cáceres.
  • Carlos A. Jiménez-Ruiz Unidad Especializada en Tabaquismo. Hospital Clínico San Carlos, Madrid.

DOI:

https://doi.org/10.20882/adicciones.1583

Palabras clave:

Asma, tabaquismo, tratamiento, consenso, recomendaciones.

Resumen

La prevalencia de tabaquismo activo en adultos con asma es similar a la de la población general. El tabaquismo se asocia con un peor control clínico de la enfermedad, una disminución acelerada de la función pulmonar y una respuesta irregular a la terapia con glucocorticoides. El consumo de tabaco impacta negativamente en la calidad de vida de los pacientes asmáticos y provoca un incremento en el número de visitas y de hospitalizaciones por exacerbaciones. Además, el tabaquismo aumenta el riesgo de cáncer de pulmón, comorbilidades cardiovasculares y muerte en pacientes asmáticos. A pesar de todo ello, las guías actuales del manejo del asma no incluyen recomendaciones específicas para el manejo de los pacientes asmáticos fumadores. Por este motivo, se procedió a una revisión narrativa de la literatura para un consenso mediante metodología de grupo nominal desarrollada a lo largo del año 2019 para extraer recomendaciones prácticas que permitieran mejorar el diagnóstico y el tratamiento del asma en fumadores, así como el tratamiento del tabaquismo en asmáticos. Las conclusiones y recomendaciones fueron validadas en el congreso nacional de la SEPAR del mismo año. Entre las más relevantes, se incidió en la necesidad de abordar el tabaquismo en las personas con asma mediante consejo sanitario, tratamiento farmacológico y terapia conductual, al ser un factor que impacta negativamente en la sintomatología, el pronóstico y la respuesta al tratamiento del asma. En el fumador con sospecha de asma, se debe evaluar la presencia de enfisema y el diagnóstico diferencial de otras enfermedades y considerar el impacto del tabaquismo en el resultado de las pruebas diagnósticas. También se concluye que el hábito tabáquico reduce la respuesta al tratamiento con corticoides inhalados, por lo que se recomienda terapia combinada con broncodilatadores.

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2021-06-15

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