Impact of tobacco smoke on chronic rhinosinusitis: A review of the literature

Douglas D. Reh, Thomas S. Higgins, Timothy L. Smith

Research output: Contribution to journalArticlepeer-review

83 Scopus citations


Background: Environmental factors such as inhaled pollutants like cigarette smoke may play a significant role in diseases of the upper airway including chronic rhinosinusitis (CRS). The objectives of this review are to summarize prior studies that describe the correlation between active smoking and secondhand smoke (SHS) on CRS. We also review the pathophysiologic effects of cigarette smoke on sinonasal mucosa and discuss its impact on surgical outcomes of endoscopic sinus surgery (ESS). Methods: A literature search was conducted of the PubMed database using the terms "sinusitis" or "rhinosinusitis" and "smoking." Additional search terms of "nasal epithelial" and "smoke" were used to find articles that discussed pathophysiologic effects of tobacco smoke, whereas "secondhand smoke" was added to identify articles analyzing the correlation of SHS and CRS. Finally "endoscopic sinus surgery" and "outcomes" were linked to "smoking" to find articles that analyzed the impact of smoking on surgical results. Results: We identified 204 articles in the initial search. An additional 72 articles were reviewed for their relevance to the pathophysiologic effects of tobacco smoke while 31 articles were analyzed to determine the correlation of SHS and CRS. Twenty-nine articles were reviewed to analyze the impact of smoking on surgical results. Conclusion: There is clear evidence in the literature that cigarette smoke, either through active smoking or passive exposure to SHS, contributes to CRS. Recent prospective studies suggest that active smoking is not a contraindication to ESS, whereas the impact of smoking volume and long-term smoking after ESS has not been sufficiently evaluated.

Original languageEnglish (US)
Pages (from-to)362-369
Number of pages8
JournalInternational Forum of Allergy and Rhinology
Issue number5
StatePublished - Sep 2012


  • Endoscopic surgical procedure
  • Epithelial cells
  • Etiology
  • Outcome assessment
  • Sinonasal
  • Sinusitis
  • Smoking
  • Tobacco
  • Tobacco smoke pollution

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology


Dive into the research topics of 'Impact of tobacco smoke on chronic rhinosinusitis: A review of the literature'. Together they form a unique fingerprint.

Cite this