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Background: Cigarette smoking is common in adult asthmatic patients and the smoking rates in these patients are similar to those in the general population. However, adult asthmatics who are current smokers or ex-smokers have been excluded in many clinical studies. Objective: We investigated the impacts of smoking on pulmonary functions and clinical features of asthmatics by using a data from a recently established adult asthma cohort: COREA (Cohort for Reality and Evolution of Adult Asthma). Method: COREA is a Korean adult asthma cohort established since 2005. 1,283 asthma patients were enrolled in this COREA. The patients in this cohort were divided into 3 groups; the current smoker group, the ex-smoker group and the non-smoker group according to the status of smoking. We analyzed and compared the clinical and laboratory parameters of these 3 groups using clinical data, symptom score, pulmonary functions, and quality of life score. Result: Among 1,283 asthmatic patients, 16% were current smokers, 38% were ex-smokers, and 46% were non-smokers. The current smoker and ex-smoker groups were male dominant. Ex-smokers were older and had a longer history of asthma symptoms, mean treatment duration and smoking. Currently smoking asthmatics coughed more frequently in past 3 months. Current smokers and ex-smokers presented significantly lower FEV1, FVC, FEV1/FVC than non- smokers (P<0.05). Elevated total serum IgE levels were observed in the current smoking and ex-smoking asthmatics groups. In an induced sputum analysis, eosinophil counts were observed to be reduce in the current smoking asthmatic group. Conclusion: The results of this study indicated that smoking has deteriorating effects on pulmonary functions and clinical respiratory symptoms in asthmatic patients. Education for quitting smoking in asthmatics should be stressed for a better control of asthma. (Korean J Asthma Allergy Clin Immunol 2008;28:263-270)

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