Lessons Learned

The federal government’s Centers for Disease Control recently released statistics on the rates of current cigarette smoking among high-school students and adults in the United States.  The news was good: the percentage of high-school students (19.5%) and adults (19.3%) who are currently smoking cigarettes reached the lowest levels in 45 years. Given that in the U.S. cigarette smoking is the number one preventable cause of respiratory illness and death, this news is good for the health of the nation.

From the perspective of those with asthma, it is particularly encouraging. Cigarette smoking and second-hand cigarette smoke exposure are associated with worse symptoms of asthma. Cigarette smoking during pregnancy is thought linked to an increased risk that the newborn will develop asthma (and other respiratory illness). Cigarette smoking predisposes to respiratory tract infections that provoke asthmatic attacks. When parents stop smoking or smoke only outside of the home, children with asthma breathe better.

Why is it that fewer Americans are taking up cigarette smoking and more are quitting, despite billions of dollars spent by the manufacturers of cigarettes to encourage smoking? There is no single reason. In our opinion it is the combination of all anti-smoking efforts taken together that have successfully turned the tide. Each component of the anti-smoking campaign contributes: smoking bans in public places; cigarette taxes that drive up the cost; media campaigns vividly portraying the devastating consequences of emphysema, lung cancer, throat cancer, etc.; physician training in smoking cessation counseling; free community-based smoking cessation programs; and others. All together these efforts are slowly but steadily working to counter the powerful addictive allure of cigarette smoking.

We think that there is a lesson to be learned for treating and ultimately curing asthma. A single intervention that prevents its development or cures asthma in those living with the disease seems unlikely anytime soon. But multiple groups of scientists working together to understand the key processes involved in asthma; clinicians seeking better treatment strategies; pharmaceutical companies pursuing newer, safer medications; advocacy groups focusing attention on the importance of the disease; educators sharing information on the knowledge, skills, and attitudes needed to manage asthma effectively; local, state, and national asthma disease prevention and control programs working to create innovate programs, including promotion of healthier home and work environments; and patients and families helping other patients and families – these are some of the elements of a multi-pronged effort that will ultimately reduce asthma suffering and the risk of asthma attacks and death. Collaboration and sharing are key.

And the pay-off is not a remote pipedream. Already there is cause for encouragement. Although the number of persons in the U.S. with asthma remains high and is perhaps still on the rise, the number of persons hospitalized with asthma attacks or dying from asthma has been steadily decreasing for the last 10 years. Better care and better outcomes are realities within reach.