- How Smoking Harms Your Sinuses
- Secondhand Smoke (SHS) Facts
- Patterns of Secondhand Smoke Exposure
- Differences in Secondhand Smoke Exposure
- What You Can Do
- How it can affect your family:
- What can I do?
- Chronic Cough Overview
- It’s time to talk about post-nasal drip
- What is post-nasal drip?
- What causes post-nasal drip?
- What are the signs of post-nasal drip?
- How do I treat post-nasal drip?
- When should I see a doctor for post-nasal drip?
- Sinusitis and Secondhand Smoke
How Smoking Harms Your Sinuses
To understand how smoking damages your sinuses, you need to know how your nose and sinuses help keep you healthy. The membranes in your nose and sinuses are constantly producing mucus that acts as a protective blanket for your whole respiratory system.
“The lining of the nose and sinuses is the same as the lining in the lung. There are cilia, or tiny hair-like structures, that clean the nose, sinuses, and lungs of airborne particulate matter, bacteria, and mucus,” explains Kathleen L. Yaremchuk, MD, an ENT (ear, nose, and throat) doctor and chairman of the department of otolaryngology at Henry Ford Hospital in Detroit. “Smoking causes the cilia to stop working, which predisposes the smoker to increased infections of the lungs and sinuses.”
The nose and sinuses produce about one to two quarts of mucus every day, according to Samer Fakhri, MD, associate professor of otolaryngology at the University of Texas Medical School in Houston. “Normally, all that mucus travels to the back of your throat and you swallow it. When the cilia are damaged by smoking, the mucus backs up in the sinuses and bacteria start to multiply there. This can lead to a sinus infection.”
The Link Between Smoking and ENT Issues
As soon as you inhale tobacco smoke, it starts to irritate your whole upper airway. Irritating gases like ammonia and formaldehyde cause your nose and sinuses to produce more mucus. You become more susceptible to colds and allergies and, eventually, to cancer of the throat and lungs.
Dr. Fakhri says there are additional ENT-related hazards linked to smoking:
- Chronic sinusitis. “If you continue to smoke when you have a sinus infection, you are more likely to develop chronic sinusitis,” he says.
- Compromised surgical results. “If you need surgery for sinus disease, the results are much worse for smokers,” says Fakhri.
- Negative effects on senses. Smoking can lead to a decreased sense of taste and of smell.
- Cancer. Prolonged exposure to smoking has been linked to nose and sinus cancers.
- Second-hand smoke. “Secondhand smoke has been linked to snoring, respiratory infections, and ear infections in children,” warns Fakhri.
Fakhri also says that smoking has been shown to decrease immune function, which is your body’s defense mechanism against diseases. Once you stop smoking, he says, it can take the nose and sinuses several months to several years to get back to normal.
Smokers spend 25 percent more time in the hospital than nonsmokers, are twice as likely to die before age 65, and may lose up to 20 minutes of life for every cigarette they smoke.
ENT doctors see the up-close results of smoking on the nose, sinuses, and throat, so their advice is based on experience: Smoking and good sinus health don’t mix.
Find more information in the Everyday Health Ear, Nose, and Throat Center.
Secondhand Smoke (SHS) Facts
Health Effects in Adults
In adults who have never smoked, secondhand smoke can cause:
- Heart disease
- For nonsmokers, breathing secondhand smoke has immediate harmful effects on the heart and blood vessels.1,3
- It is estimated that secondhand smoke caused nearly 34,000 heart disease deaths each year during 2005–2009 among adult nonsmokers in the United States.1
- Lung cancer1,7
- Secondhand smoke exposure caused more than 7,300 lung cancer deaths each year during 2005–2009 among adult nonsmokers in the United States.1
Smokefree laws can reduce the risk for heart disease and lung cancer among nonsmokers.1
Patterns of Secondhand Smoke Exposure
Exposure to secondhand smoke can be measured by testing saliva, urine, or blood to see if it contains cotinine.3 Cotinine is created when the body breaks down the nicotine found in tobacco smoke.
Secondhand Smoke Exposure Has Decreased in Recent Years
- Measurements of cotinine show that exposure to secondhand smoke has steadily decreased in the United States over time.
- During 1988–1991, almost 90 of every 100 (87.9%) nonsmokers had measurable levels of cotinine.7
- During 2007–2008, about 40 of every 100 (40.1%) nonsmokers had measurable levels of cotinine.7
- During 2011–2012, about 25 of every 100 (25.3%) nonsmokers had measurable levels of cotinine.8
- The decrease in exposure to secondhand smoke is likely due to:8
- The growing number of states and communities with laws that do not allow smoking in indoor areas of workplaces and public places, including restaurants, bars, and casinos
- The growing number of households with voluntary smokefree home rules
- Significant declines in cigarette smoking rates
- The fact that smoking around nonsmokers has become much less socially acceptable
Many People in the United States Are Still Exposed to Secondhand Smoke
- During 2011–2012, about 58 million nonsmokers in the United States were exposed to secondhand smoke.8
- Among children who live in homes in which no one smokes indoors, those who live in multi-unit housing (for example, apartments or condos) have 45% higher cotinine levels (or almost half the amount) than children who live in single-family homes.9
- During 2011–2012, 2 out of every 5 children ages 3 to 11—including 7 out of every 10 Black children—in the United States were exposed to secondhand smoke regularly.8
- During 2011–2012, more than 1 in 3 (36.8%) nonsmokers who lived in rental housing were exposed to secondhand smoke.8
Differences in Secondhand Smoke Exposure
Racial and Ethnic Groups8
- Cotinine levels have declined in all racial and ethnic groups, but cotinine levels continue to be higher among non-Hispanic Black Americans than non-Hispanic White Americans and Mexican Americans. During 2011–2012:
- Nearly half (46.8%) of Black nonsmokers in the United States were exposed to secondhand smoke.
- About 22 of every 100 (21.8%) non-Hispanic White nonsmokers were exposed to secondhand smoke.
- Nearly a quarter (23.9%) of Mexican American nonsmokers were exposed to secondhand smoke.
- Secondhand smoke exposure is higher among people with low incomes.
- During 2011–2012, more than 2 out of every 5 (43.2%) nonsmokers who lived below the poverty level were exposed to secondhand smoke.
- Differences in secondhand smoke exposure related to people’s jobs decreased over the past 20 years, but large differences still exist.
- Some groups continue to have high levels of secondhand smoke exposure. These include:
- Blue-collar workers and service workers
- Construction workers
What You Can Do
You can protect yourself and your family from secondhand smoke by:2,3,4
- Quitting smoking if you are not already a nonsmoker
- Not allowing anyone to smoke anywhere in or near your home
- Not allowing anyone to smoke in your car, even with the windows down
- Making sure your children’s day care center and schools are tobacco-free
- Seeking out restaurants and other places that do not allow smoking (if your state still allows smoking in public areas)
- Teaching your children to stay away from secondhand smoke
- Being a good role model by not smoking or using any other type of tobacco
- U.S. Department of Health and Human Services. The Health Consequences of Smoking—50 Years of Progress: A Report of the Surgeon General. Atlanta: 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 Health, 2014 .
- U.S. Department of Health and Human Services. A Report of the Surgeon General: How Tobacco Smoke Causes Disease: What It Means to You. Atlanta: 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 Health, 2010 .
- U.S. Department of Health and Human Services. The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General. Atlanta: 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 Health, 2006 .
- Huang J, King BA, Babb SD, Xu X, Hallett C, Hopkins M. Sociodemographic Disparities in Local Smoke-Free Law Coverage in 10 States. American Journal of Public Health 2015;105(9):1806–13 .
- Institute of Medicine. Secondhand Smoke Exposure and Cardiovascular Effects: Making Sense of the EvidenceExternal. Washington: National Academy of Sciences, Institute of Medicine, 2009 .
- National Toxicology Program. Report on Carcinogens, Fourteenth EditionExternal. Research Triangle Park (NC): U.S. Department of Health and Human Services, Public Health Service, 2016 .
- Centers for Disease Control and Prevention. Vital Signs: Nonsmokers’ Exposure to Secondhand Smoke—United States, 1999–2008. Morbidity and Mortality Weekly Report 2010;59(35):1141–6 .
- Centers for Disease Control and Prevention. Vital Signs: Disparities in Nonsmokers’ Exposure to Secondhand Smoke—United States, 1999–2012. Morbidity and Mortality Weekly Report 2015;64(4):103–8 .
- Wilson KM, Klein JD, Blumkin AK, Gottlieb M, Winickoff JP.Tobacco Smoke Exposure in Children Who Live in Multiunit Housing. External Pediatrics 2011:127(1):85-92 .
- Arheart KL, Lee DJ, Dietz NA, Wilkinson JD, Clark III JD, LeBlanc WG, Serdar B, Fleming LE. Declining Trends in Serum Cotinine Levels in U.S. Worker Groups: The Power of Policy. Journal of Occupational and Environmental Medicine 2008;50(1):57–63 .
There has been mounting evidence connecting exposure to secondhand smoke to illness and diseases due to the irritating nature of tobacco smoke on the non-smoker.
Despite significant educational efforts, epidemiologic evidence, and reports from the United States Surgeon General, smoking and smoking-related conditions are a major health concern. The irritating nature of tobacco smoke on the non-smoker has long been recognized. Since the 1960’s, there has been mounting evidence connecting exposure to secondhand smoke to illness and disease.
Secondhand smoke is a term used for the involuntary exposure of nonsmokers to tobacco smoke from smokers. Another commonly used term is Environmental Tobacco Smoke. Secondhand smoke is a mixture of side stream smoke given off by the smoldering cigarette, pipe, or cigar and mainstream smoke exhaled into the air by active smokers. Third hand smoke refers to smoke components deposited on surfaces.
In the News:
The Global Burden of Disease Study done in 2010 estimated that exposure to secondhand smoke is responsible for 601.000 premature deaths annually worldwide. It is estimated that 28% of the mortality and 61% of the morbidity is seen in children. Secondhand smoke has been found to be a cause of lung cancer by several epidemiologic studies. Cardiac disease has also been causally associated with secondhand smoke exposure in adults. Mounting evidence also points to secondhand smoke exposure as a cause or aggravator of a variety of adverse respiratory conditions including asthma, pneumonia, bronchitis, reduced lung function, sinusitis, and COPD. Secondhand smoke exposure is also implicated as a cause of middle ear disease, sensorineural hearing loss, sudden infant death syndrome, prematurity, impaired fetal growth and development, dental caries, cancers in locations other than the lungs, renal disease, and atherogenesis.
How it can affect your family:
The level of tobacco exposure of the fetus of a mother who smokes is the same as the level for an active smoker. There is a higher risk of stillbirth and neonatal deaths among newborns of smoking mothers. Maternal smoking during pregnancy reduces birth weight on an average of 200 grams. Active smoking of the mother during pregnancy is also associated with an increase in a large variety of non-chromosomal birth defects. Cognitive deficits tend to be more prevalent in children whose mothers smoked during pregnancy. Exposure of the non-smoking mother to secondhand smoke during pregnancy has been associated with an increased incidence of low birth weight, stillbirth, and congenital malformations.
The Global Study of Disease Burden from exposure to secondhand smoke estimates that 165,000 children under the age of 5 worldwide die annually because of lower respiratory infections attributed to secondhand smoke exposure. Chronic exposure to secondhand smoke is linked to an increased prevalence and severity of asthma. There is also evidence that secondhand smoke exposure promotes and facilitates allergic sensitization. Children with chronic secondhand smoke exposure enter adulthood with less pulmonary reserve and decreased lung function.
Exposure of children and adolescents to parental smoking has been associated with advancement of the vascular age by 3.3 years by measurement of carotid artery thickness. This increases the risk of developing carotid atherosclerotic plaques in adulthood even with adjustments being made for other risk factors such as blood pressure, lipid levels, and personal smoking status. There is growing concern about increased risks of coronary artery disease in adults and children exposed to secondhand smoke.
What can I do?
Reducing and preferably eliminating secondhand smoke in the home and in vehicles is critical since these are the major locations of exposure for children and non-smoking adults. Secondhand smoke cannot be controlled by air cleaning and filtration, or building ventilation. These findings on the effects of secondhand smoke are the foundation for the drive for smoke-free indoor environments and for educating parents and the community on the adverse health effects. Policies that ban all indoor smoking in workplaces and public places are highly effective in reducing smoke exposure. Only complete bans of smoking in indoor environments are effective. Segregation of smokers and non-smokers within the same indoor environment may reduce some of the exposure, but does not eliminate it.
Bonita Wilson, MD
Chronic Cough Overview
What is chronic cough?
Chronic cough is usually defined as a cough that lasts more than eight weeks. Chronic cough is one of the most frequent reasons for visits to the doctor. Chronic cough is not a disease itself. It is a health problem that results from other health conditions.
What are some of the health problems that cause chronic cough?
Chronic cough is usually caused by these health problems:
- Smoking: Smoking is the number one cause of chronic cough.
- Asthma:This is the second most frequent cause of chronic cough. Shortness of breath and wheezing are byproducts of asthma. These breathing difficulties can result in a chronic cough. On the other hand, chronic cough may be the only symptom of asthma.
- Acid reflux: Gastroesophageal reflux disease (GERD) occurs when stomach acid backs up into the esophagus. Symptoms of GERD include heartburn, chest pain, wheezing and shortness of breath. Irritation caused by these symptoms can lead to chronic cough.
- Sinusitis and post nasal drip: Frequent sinus infections can cause post-nasal drip, (sometimes called “a tickle in the back of the throat”), and drainage can trigger chronic cough. The “tickle” occurs when a larger-than-normal amount of mucus runs down the back of the throat.
- Allergies: Chronic cough can result from inhaling dust, pollen, pet dander, chemical/industrial fumes (over many years), molds, freshly cut grass, and other irritants.
- Bronchitis: Inflammation (swelling) of these airway passages can cause shortness of breath and wheezing and result in chronic cough.
- Upper respiratory infections: Lengthy bouts of colds, the flu, pneumonia or other infections can lead to the development of chronic cough. Whooping cough (pertussis) occurs more commonly in infants and young children.
- Chronic obstructive pulmonary disease (COPD): This is a lung condition that occurs most often in smokers. It is caused by a build-up of mucus in the lungs, which the body tries to clear by coughing. COPD includes the related conditions, emphysema and chronic bronchitis.
- High blood pressure drugs: ACE inhibitors are a specific category of drugs used to treat high blood pressure. A side effect of these drugs is chronic cough. Some common ACE inhibitors are lisinopril (Prinivil®, Zestril®), enalapril (Vasotec®), peridopril (Aceon®), captopril, (Capoten®), and ramiparil (Altace®)
- Lung or other airway cancers: Rarely, chronic cough can be a sign of either a lung cancer or cancer in the upper airway.
What are the symptoms of chronic cough?
Often, the cough itself is the only symptom of chronic cough.
Other symptoms can include:
- A runny/stuffy nose.
- Post-nasal drip (‘tickle’ in the back of the throat).
- Wheezing/shortness of breath.
- Weight loss without any effort.
- Coughing up phlegm or blood.
- Throat pain.
- Frequent throat clearing.
- Hoarse voice.
- Fever (higher than 101°F).
- A drenching overnight sweat.
What are the complications of chronic cough?
- Physical exhaustion.
- Insomnia (inability to sleep).
- Disruption of the daily routine.
- Muscle discomfort.
- Hoarse voice.
- A drenching sweat.
- Urinary incontinence (loss of bladder control).
- Minor bleeding in the eye.
- Broken ribs.
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It’s time to talk about post-nasal drip
Post-nasal drip is something mentioned everywhere, from your doctor’s office to TV, but people don’t often explain exactly what it is. Today’s blog is here to help with that.
What is post-nasal drip?
Mucus is a substance that helps protect your body from viruses, bacteria, and other foreign invaders. Your nose makes about a quart of mucus a day. Normally you don’t notice it because it drips harmlessly down the back of your throat. However, if your body is producing more than normal, or its thicker than normal, it becomes more noticeable. If it comes out your nostrils, you have a runny nose. If it runs down the back of your nose and into your throat, you have post-nasal drip.
What causes post-nasal drip?
Post-nasal drip has a variety of causes, including colds, the flu, sinus infection, and allergies. You can also get it from some medications, objects in the nose, chemical fumes, changing weather, acid reflux, and some foods. Some people, particularly older patients, experience it when they’re eating, in a condition called vasomotor rhinitis, CEENTA ENT doctor Mark Abrams, MD, said. Even pregnancy can cause post-nasal drip.
What are the signs of post-nasal drip?
You may feel liquid running down the back of your throat. You also may have a cough, hoarseness, and a scratchy, itchy, or even sore throat. You may also feel nauseous or find yourself coughing up more mucus.
How do I treat post-nasal drip?
Fortunately, there are many ways to treat post-nasal drip at home. An over-the-counter decongestant or antihistamine can help eliminate the mucus. Similarly, a nasal spray can flush out the mucus or help clear blocked airways. Dr. Abrams also recommends using NeilMed Sinus Rinse. Patients with vasomotor rhinitis are often treated with Atrovent.
You can also try to drink more water, since that will help thin out the mucus. If you have a humidifier, try running it, since it will counteract the dry air that could be worsening your post-nasal drip. Avoid irritants like cigarette smoke as much as possible. If your drip is related to allergies, try to avoid the allergens, too.
You could also try sleeping with your head propped, since it will help your nose drain and reduce mucus in your throat and airway.
When should I see a doctor for post-nasal drip?
People with discolored or foul-smelling mucus, have post-nasal drip lasting longer than 10 days, or have other symptoms like a fever should see a doctor, since these are signs of an infection or other illness.
Post-nasal drip is nothing to sniff at, but you can breathe easy knowing it can be an easy condition to treat.
This blog is for informational purposes only. For specific medical questions, please consult your physician. Dr. Abrams practices in our Rock Hill office. To make an appointment with him or a CEENTA ENT doctor near you, call 704-295-3000. You can also request an appointment online or through myCEENTAchart.
Melanie Cole (Host): Have you ever had that feeling of mucus that accumulates in your throat and you’re not sure what that means. My guest today is Dr. Steven Lyon. He’s a board certified otolaryngologist at Stoughton Hospital. Welcome to the show, Dr. Lyon. So, people get that feeling: sometimes it causes a cough, sometimes they feel like it’s a post-nasal drip. What’s going on when we feel that throat drainage?
Dr. Steven Lyon (Guest): Melanie, this is one of the most common things that people come to the office with complaints about. It’s very, very common. So, I think it’s important to have people understand some of the major causes and make it so that they can describe these things to their doctors and help the doctor come up with the proper treatment. This is really mostly drainage that you feel but you can’t usually see abnormal drainage. You can feel an abnormality in your throat or in your nose and you feel like there’s something in there. It’s important to remember that the nose–and this is something that really surprises people–because the nose puts out two quart of mucus a day. Of course, your mouth is always putting out saliva and this runs down the back and is actually there to lubricate your mucus membranes. The lining of your nose and your throat are supposed to have that because that’s what we call them “mucus membranes”. The idea of post-nasal drainage is kind of a funny misnomer because, really, we all should have mucus and drainage in the throat. The question is, if we feel it what’s going on? Why is there that sensation? Why does it feel abnormal to us? Everybody can really produce some of that, you can always spit up a little bit of it but trying to understand what really is behind the problem is going to help you get to the solution. It’s really important to understand that it’s not all about allergies, though allergies can be a cause. You need to think about the individual symptoms, help your doctor with the diagnosis, and help them help you with the proper treatment. If you go in and you say the word “drainage”, and it’s not drainage, you may get treated for drainage, and then it won’t get better. The first thing to understand is that these causes aren’t necessarily individual causes; they frequently overlap and many people have more than one. You mention things like smoking and other sources of throat irritation. Anything that can irritate your throat can either dry your throat or make it feel like there’s something stuck in there. That will give us a sense or enhance the sense of post nasal drainage, so we have to think about all the sources of the throat irritation whether it be smoking, or working in a dusty environment, or irritation from chemicals in the environment, or some people are very sensitive to smells and perfumes and things like that. One thing that I like to have people first understand is that they should separate the sensation of post-nasal drainage or nasal drainage from the dripping of the front–the watery drippy runny nose that people sometimes get. That comes in basically two varieties, there’s something that we call nasal rhinitis. It’s frequently when an older person comes in and their nose runs like a faucet and they’re constantly having to block drips and blow their nose, and they have handkerchiefs at the ready all the time but they don’t have typical symptoms of allergies like sneezing, itching, runny nose, and scratchy eyes but they do have that watery, dripping nose. Sometimes that’s made worse by having a meal, smelling a smell, going outside, the cold, and changes in temperature, things like that. That’s not post-nasal drip, that’s a drippy nose. That’s something that requires a different treatment but that’s what we’re really talking about today. Another one is allergies. Of course, allergies increase the volume of the mucus and they can have that mucus either come out the front and drip, or they can go down the back and that produces some actual increase in the nasal drainage but it’s usually accompanied by symptoms that we are pretty familiar with because the allergies are so common: things like sneezing, itchy, runny, watery, and scratchy eyes, scratchy throat and that sort of thing. Sometimes we know that there’s an exposure whether it’s pollens, or trees, or grass, or animals. We generally have this and there’s an exposure that can make this worse or trigger it but some of the causes of the sensation of post-nasal drip aren’t necessarily quite so straightforward. There are many patients who have swelling of their mucus membrane and the structures in the nose, and they’ll feel a sense of drainage in the nose but when they blow their nose nothing comes out. When they move from one side to the other when they’re sleeping, the drainage seems to move from side to side. We all sense this to some extent because some of this is normal as the blood flow switches from side to side with the changes in the position when we lie down or when we are sleeping. But, for some people this is much more pronounced, and so theirs is a situation where it’s not really a drainage; it’s not really a mucus. It’s the filling up of your nasal cavities with the tissue that becomes swollen in your nose. Unless we treat that swelling or understand what’s causing the swelling, we won’t really get any relief from that and there are certain medications that are common in causing and making this sort of thing worse. One of the most common medications people are on is for their prostate or to be able to urinate because that tends to cause the mucus membrane to swell. As I said, they really don’t come alone or singly. Many of them are associated with other problems, whether you have obstruction from a combination of things like what we call a “deviated septum” in the nose, and crooked breathing passages, or a combination of those with allergies, or a chronic sinus problem. Another common source that people refer to as post-nasal drainage is simply actually dryness–dry mouth, where people feel like their mouth is parched and sticks, and it makes it hard to swallow and this sort of thing. In contrast to having more drainage, they actually have less mucus, less drainage in the throat. It doesn’t feel normal. It doesn’t work normal and neither does the nose. When the nose is dry, it feels stuffy. So, the key here is to increase their intake of water, use maybe a nasal moisturizing spray. Keep a little cup of water or water bottle at the bedside so that you can moisten your throat if you wake up with a dry mouth. Or, you can use things like salivary replacements. This is another thing that is aggravated by smoking because if your mucus membranes are dry, then they’re not protected well. If you smoke and you’re using your throat like a chimney, then that smoking can aggravate any irritation in your throat and make that sensation worse. Now one of the other frequent causes of the drainage sensation is actually what we call “reflux”, many people refer to this as “silent reflux” because it doesn’t cause overt symptoms that you are familiar with like heart burn. What do people get when they have reflux and how can you tell if that’s the source of your post-nasal drainage symptoms? Well, people tend to have symptoms that are with reflux that are worse in the morning. They’ll feel like there’s a glob in the throat or sense that there’s drainage stuck in the throat, and they’ll clean the throat frequently and this sort of thing but they won’t see any actual normal mucus coming out, frequently because the stomach acid has actually traveled up the esophagus and into the back of the throat, they can get hoarse and they can irritate the vocal cord, so they can get a sore throat. So, these people will benefit from dietary changes and potentially being on a medication to reduce the acids up and make it so that it’s quite not so irritating but things like eating late, going to bed, or lying down, or exercising with full stomach, with head of the bed elevated and that sort of thing. But, again, this is something that’s not clearly associated with a real post-nasal drainage or drainage you could see but it’s a sensation of drainage.
Melanie: Dr. Lyon, you’ve given us so many different bits of good advice about why this could be caused, things that we can do. So, wrap it up and give us some things that you really want people to first try at home and then, if this is still a problem, something that’s really aggravating them and, as you say, causing coughing and all of the things that make life very difficult for somebody with severe throat drainage. Give us some home remedies, things you want people to try like humidifiers, nasal sprays, whatever, and then tell them when they really should see a doctor.
Dr. Lyon: I think that’s really what it comes down to, is trying to get relief. One simple way to think about it is if it is dry, then wet it. Use nasal saline and then drink an extra drink or two of water. Those are things that are simple to do and give you a simple answer about whether that’s playing a significant role in your symptoms. Cutting down your smoking, looking at the sources of potential irritation in your nose and your throat, and removing those sources of irritation. Smoking is a simple one to recognize but not such a simple one to defeat. It’s important to take that next step and try and reduce or stop the smoking. Pay attention to signs for instant of chronic sinusitis. Patients who have maybe a pressure sensation and really will have occasional very, very thick or abnormal glue like secretions that come up. Those patients will frequently benefit from nasal irrigation and many patients who have that and other sources of inflammation can use a nasal steroid spray which now are available over the counter for use. I think it’s important to take these steps at home, to try and narrow down some of the possibilities. See what gives you relief; see what doesn’t give you relief. That’s more information you can bring to your doctor so that they can understand what steps you’ve already taken and what other medications or possibly changes in the medications you’re already on because those might be contributing to some of the symptoms too. There are lots of options. Certainly, if people have allergies then the use of the nasal steroids sprays, or, potentially antihistamines to control their sneeze, itchy, watery, runny symptoms can go a long way to helping these symptoms. The important thing is to think about what the possible causes are and try and manage some of the more common causes at home. Decrease the sources of irritation in your nose and your throat and keep good notes so that you can give those ideas to your doctor and use the doctor’s treatment, if the treatment at home doesn’t help.
Melanie: Thank you so much for being with us today, Dr. Lyon. You’re listening to Stoughton Hospital Health Talk. For more information you can go to www.stoughtonhospital.com. That’s www.stoughtonhospital.com. This is Melanie Cole. Thanks so much for listening.
Sinusitis and Secondhand Smoke
Researchers compared secondhand smoke exposures among patients with chronic sinusitis to non-sinus sufferers matched for age, sex, and race in four settings: home, work, public settings, and private social gatherings. None of the study participants smoked.
Participants with chronic sinusitis were almost twice as likely as those without sinusitis to report secondhand smoke exposure at social gatherings (51% vs. 28%) and slightly more than twice as likely to report exposure at work (18% vs.7%).
The patients were also more likely to report exposure at home and in public places, although these associations did not reach statistical significance.
The more places people reported being exposed to tobacco smoke, the higher their risk for chronic sinusitis, study researcher C. Martin Tammemagi, DVM, PhD, tells WebMD.
Tammemagi is an associate professor at Brock University in Ontario, Canada.
The research appears in the April issue of the Archives of Otolaryngology-Head and Neck Surgery. It was funded by the Flight Attendant Medical Research Institute in Miami.
“Ours is one of the first studies to connect secondhand smoke to rhinosinusitis,” Tammemagi says. “Our research confirms that people are being exposed in large numbers and it indicates that about 40% of cases are caused by secondhand smoke.”
The finding that private social gatherings are an important contributor to secondhand smoke exposure was somewhat surprising, Tammemagi says.
“Certainly from a public policy point of view, limiting these exposures is not easy,” he says. “But people with sinus problems need to recognize that exposure when they go to a party or a card game at a friend’s house puts them at risk.”
Q. Can smoking harm your sinuses?
A. Smoking is one of the major culprits contributing to lung disease and other respiratory problems, including sinusitis (sinus infection). Cigarette smoke damages and in severe cases destroys the delicate hair-like structures “cilia” found in the sinus membranes. The cilia in your sinus membranes can re-grow, however this requires the person to stop smoking.
Cigarette smoke (either by smoking or due to second hand smoke) could irritate the delicate mucus membrane linings and may also cause a person to experience swelling and intolerable discomfort in the sinus area (i.e. facial region)
Q. What does smoking do to you?
A. Smoking can harmfully affect your body in several ways. The harmful effects of smoking occur mostly to the respiratory system. Cigarette smoke is the one of the most notorious irritants that aggravates asthma and sinus infections. When you smoke or inhale cigarette smoke (passive or secondhand smoking), you become twice as susceptible to getting asthma or cancerous disorders.
Bronchi or bronchial tubes extend from the windpipe (trachea) into the lungs. These tubes (bronchi or bronchial tubes) are responsible for carrying air both into and out of the lungs. When the tissues lining the interior of these tubes become inflamed due to any harmful substances that you inhale, you increase your risk of developing asthma.
An asthma sufferer’s bronchial tubes are highly sensitive to many triggers like smoke or other air-borne irritants. When tobacco smoke is inhaled, the irritant settles in the lining of these airways which may cause the person to experience an asthma attack.
Also, when cigarette chemicals mingle with the saliva in your mouth, a cancerous substance that may have devastating effects is produced. Tobacco chemicals destroy all protective components of saliva, leaving a corrosive mixture that hampers the mouth cells. This may cause a person to suffer with bad breath and may even predispose one to mouth cancer.
Smoke substances such as cigarette smoke or pollutant smoke are one of the primary causes of sinusitis and other respiratory ailments. When you constantly inhale any form of smoke, your cilia (hair-like structures in your sinus membrane that function to sweep the secretions out of the sinuses to the back of the throat) becomes impaired resulting in a slowing down of nasal drainage. Mucus may then collects in the sinus cavities creating more congestion which may result in a sinus headache or a sinus infection.
Q. How does smoking damage your sinuses?
A. Every adult produces approximately two quarts of mucus in the nose and sinuses each day. Most of this mucus is carried through the nose and drips down the back of the throat where it is swallowed unconsciously. We generally are unaware of this process since it is facilitated by the cilia.
Cigarette smoke hampers normal cilia functioning, slowing down their normal cleansing properties. When the cilia become impaired due to tobacco chemicals, mucus becomes stagnant and collects in the sinus cavities. The ostium (small opening leading into the nasal sinuses) also becomes obstructed due to stagnant mucus which thickens very fast, disabling proper drainage.
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