Upper airway complications of cigarette smoking.

Passive cigarette smoking is becoming increasingly implicated in upper respiratory tract infections. Some 9 million to 12 million children have significant exposure to cigarette smoke, which may result in pathologic changes in mucociliary transport and cellular composition of the respiratory tract. The physiologic changes related to chronic smoke exposure have been implicated as a risk factor for otitis media and bronchitis. Currently, the cellular effects of cigarette smoke or mucosa can only be reversed or eliminated with avoidance. The use of intranasal steroids or cromolyn sodium, in addition to antibiotic therapy, when an infection is present may reduce the severity or incidence of disease.