Perspectives in Smoking Related Interstitial Lung Diseases

Interstitial lung disease is a generic term encompassing a wide range of unrelated conditions that have in common a tendency to cause shortness of breath and/or cough associated with bilateral abnormal opacity of various types on conventional chest X-rays or high-resolution computed tomography scans, symptoms including dyspnea, wheezing, cough, and/or sputum production. This study aimed to show that cigarette smoke is a powerful inducer of inflammation and the cause-effect relationship between cigarette smoking and interstitial diseases – respiratory bronchiolitis-associated interstitial lung disease (RB-ILD) and desquamative interstitial pneumonia (DIP). We bring to your attention the cases of two patients, heavy smokers with HRCT images suggestive for RB-ILD and DIP. The patients present to the on-call room with dry cough, exertional dyspnea and receive corticosteroid treatment with the recommendation to cease smoking. An approach would be to target high-risk populations, such as older adults with a history of smoking for early diagnosis of parenchymal lung diseases (e.g. ILD and chronic obstructive pulmonary disease) or lung cancer.