PURPOSE: Tobacco smoking is commonly believed to be negatively associated with occurrence of sarcoidosis. Relationship of environmental tobacco smoke (ETS) exposure with sarcoidosis is largely un-explored. We studied the prevalence of tobacco smoking (active and ETS exposure) and its impact on disease severity in freshly diagnosed cases of sarcoidosis from India.
METHODS: Data on demographic variables, smoking habits and exposure to environmental tobacco smoke (ETS) exposure among non smokers was collected prospectively in 98 newly diagnosed cases of sarcoidosis and 196 age, sex and religion matched healthy volunteers. Prevalence of smoking and ETS exposure was compared among cases and controls. Among the sarcoidosis patients, clinical manifestations, radiology, spirometry and histopathological grading of lung biopsy  were compared between the smokers or non smokers and ETS exposed or not-exposed patients. Data were analyzed using SPSS.
RESULTS: The study group comprised of 62 (63%) men and 36 (37%) women. The prevalence of smoking was similar in cases and controls (12.2% vs. 15.3%, p < 0.48). Among the never smoker patients with sarcoidosis, 20 (23%) reported ETS exposure vis a vis 57 (34%) in the matched controls. Multivariate logistic regression analyses showed insignificant negative association with active smoking (OR 0.77; 95% CI 0.38–1.58) or ETS exposure (OR 0.53; 95% CI 0.27–1.04) after adjusting for age, gender, religion, and education. Logistic regression model did not show any difference in the clinical manifestations, radiological staging, spirometry and histo-pathological grading of lung biopsy in any of the group comparisons studied.
CONCLUSION: Smoking or ETS exposure has no significant negative association with sarcoidosis. Also, tobacco smoke does not seem to have any effect on the clinical behavior or disease severity in sarcoidosis.
CLINICAL IMPLICATIONS: The belief that smoking is protective for sarcoidosis is not substatiated in this study and appears to be misfounded.Reference:1. Gupta D, Jorapur V, Bambery P, Joshi K, Jindal SK. Pulmonary sarcoidosis: spirometric correlation with transbronchial lung biopsy. Sarcoidosis Vasculitis Diffuse Lung Dis 1997; 14: 77-80.
DISCLOSURE: Surinder Jindal, None.