Smoking and Sinonasal Disease: A Narrative Review

Tobacco smoke includes over 4,000 potentially harmful components. This study aimed to collect relevant content to evaluate the association between smoking and sinonasal diseases. PubMed, Scopus, Web of Sciences, and Google Scholar databases were searched for related articles from inception until 2021. Of the overall 560 retrieved articles, 67 cases remained for review after the exclusion of duplicates and unrelated papers. Tobacco smoke, whether first- or second-hand, is harmful to the nose and sinuses. Smoking is linked to various sinonasal disorders, including chronic rhinosinusitis (CRS), olfactory impairment, nasal polyps, allergic and non-allergic rhinitis, and certain cancers. The formation of bacterial biofilms, dysfunctional mucociliary clearance, oxidative stress, inflammation, apoptosis and cytotoxicity, and structural changes appear to be some of the potential mechanisms through which tobacco smoke affects the sinuses and the nose. Clinicians should consider the negative consequences of smoking on sinonasal disorders when treating patients with these conditions. Cessation of smoking may benefit these patients’ health.