Smokers at increased risk of recurring pneumonia

A new study, led by experts at the University of Nottingham, has shown that people who smoke are at a higher risk of being hospitalised repeatedly with pneumonia.

Preventing hospitalisation for pneumonia, especially during winter, is one of the priorities for respiratory diseases in the NHS Long Term Plan and for the British Thoracic Society. However, there are few studies related to recurrent admission with pneumonia, and specifically no studies in the UK.

This new study, published in Thorax, is the first in the UK investigating the occurrence of, and risk factors for recurrent hospitalisation for pneumonia. It was led by Dr Vadsala Baskaran from the Nottingham Respiratory Research Unit, in the School of Medicine.

The team investigated the occurrence of recurrent pneumonia after hospitalisation from an episode of pneumonia. Within 90 days and one year of follow-up, they found that approximately 3% and 9% of patients developed recurrent pneumonia.

They also looked at the risk factors for recurrent hospitalisation for pneumonia. They found that smokers are at increased risk of recurring pneumonia. They also found that smokers had a 42% higher risk of recurring pneumonia compared to non-smokers during a year of follow-up after hospitalisation for pneumonia. The risk halved in ex-smokers at 24%.

Other factors which increased the risk of hospitalisation included- increasing age, being male, being from a low-income background and other medical conditions.

Dr Baskaran said: “Our findings confirm a high and rising incidence of recurrent hospitalisation for pneumonia in the UK. As current smokers are associated with an increased risk of recurrent pneumonia, our findings support interventions to help people stop smoking as a key component of pneumonia management. We also observed that the proportion of death (mortality) doubled during the 30-day period after hospitalisation for recurrent pneumonia compared to the initial admission for pneumonia, highlighting the need to address this important, yet under-recognised issue.

“Effective interventions to help people stop smoking should be implemented as a key component of pneumonia management. These include evidence-based stop-smoking interventions such as providing brief advice on smoking cessation, offering behavioural support, alongside medications such as nicotine replacement therapy.

“Our research also showed that ex-smokers reassuringly had a lower risk of recurrent pneumonia. Future research is warranted to establish why and for how long are ex-smokers continue to be at higher risk of developing pneumonia.”

A full copy of the study can be found here.