Smoking by itself is bad for anyone health-wise as it is one of the primary causes of lung cancer but add having sickle cell disease to tobacco smoke exposure and what happens is an increased risk of acute chest syndrome (ACS) and pain in adults.
There has been a suggested link between cigarette smoking and ACS in the patient with sickle cell anemia where this condition is characterized by cough, chest pain, fever and leukocytosis (which is an increase in the number of white cells in the blood especially during an infection).
Although the exact correlation between smoking and the development of acute chest syndrome is still speculative in the sickle cell smoker, cigarette smoking joins infection, hypoxia, infarction, dehydration and analgesics as a causative factor for pain in adolescent and adult patients with SCA. Acute Chest Syndrome is a leading cause of hospitalization and death for people with sickle cell and studies show that adults exposed to tobacco smoke or who are sickle cell smokers themselves have a higher rate of developing it than those who are not exposed to it or smoke tobacco.
Secondhand smoke is also an important aspect to consider as exposure to it has been associated with increased hospital admission and higher hospital costs. There are other sources of exposure to tobacco that are of concern which include e-cigarettes, cigars, pipes, chewing tobacco and hookah but studies are still ongoing to identify any other effects these may have on sickle cell patients.
The most common method for measurement of tobacco smoke exposure in SCD (whether first or secondhand) is indirect, either by questionnaire or interview. This however is not preferable by reason of underestimating or under reporting any tobacco smoke exposure. ACS ranges in severity and may be life threatening with even milder cases still resulting in hospitalization.
The effects of TSE on SCD are real and whether exposure in first or secondhand, it is an important area for education, guidance and additional research. The cessation of tobacco smoke exposure and reduction in secondhand smoke are needed to improve the health of children and adults with sickle cell disease. Therefore it goes without saying that the sickle cell smoker does him/herself a disservice by exposing themselves to tobacco smoke and should refrain from the habit of smoking.
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