Cigarette smoking affects many organs and remains the most preventable cause of morbidity and premature death.1–2
In lungs, it has been primarily associated to COPD and bronchogenic carcinoma. However, an increasing body of evidence supports the notion that cigarette smoke may also cause some diffuse parenchymal lung diseases. Thus, at least three interstitial lung diseases (ILDs) have been related to cigarette smoking: respiratory bronchiolitis (RB)-associated ILD (RB-ILD), desquamative interstitial pneumonia (DIP), and pulmonary Langerhans cell histiocytosis (PLCH).3–8
Although the pathogenic mechanisms that link tobacco smoke exposure to these disorders have not been elucidated, there is growing evidence that in all these diseases the primary target appears to be the terminal and/or respiratory bronchioles.