The effects of smoking on quality of life recovery after surgery for chronic rhinosinusitis

Background: The effects of smoking on quality of life (QoL) results in chronic rhinosinusitis (CRS) patients still remain a matter of debate. Objective: To explore the impact of smoking on QoL and determine how quantity of daily smoking and duration affect QoL results after endoscopic sinus surgery (ESS). Methodology: Patients with CRS were prospectively asked to evaluate their QoL pre-and after ESS. All subjects'QoL was evaluated by means of validated questionnaires either specific (Questionnaire of Olfactory Deficits), for assessing psychology (Zung Anxiety Scale, State Trait Anxiety Inventory, Zung Depression Scale and Beck Depression Inventory) or generic (Short Form 36) Smoking habits were expressed in pack-years. Results: No statistically significant differences were found in the pre-treatment scores in any of the questionnaires between smokers and non smokers. Post-operatively, all QoL questionnaires' results were significantly improved among both groups, although non smokers exhibited significantly greater improvement compared to smokers. There was a negative impact of the number of pack-years on the changes of QoL results; less improvement was observed as the number of pack-years was increasing. Conclusion: Although smoking did not influence preoperative QoL results and proved not to be a contra-indication factor for ESS regarding QoL, smokers presented worse treatment outcomes. Quantity and duration of smoking were significantly associated with worse postoperative results in all QoL questionnaires