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From Airways to Alveoli: A Review of Smoking-Related Respiratory Disorders

Aya H Rudwan, Elaf Al Adhreai, Heba E Ali, Samaa Albaik, Yara Allo, Raeda Osman, Yagen Bakhiet, Ahmed Rudwan

Cureus, 2026

1 citation

Abstract

Despite significant declines in smoking rates over recent decades, tobacco use remains a leading preventable cause of respiratory illness and death worldwide. While global smoking rates have declined, progress has slowed in many regions, and the smoking-attributable disease burden continues to rise in low- and middle-income countries due to population growth and ageing. Smoking is a major risk factor for a wide range of respiratory diseases, including chronic obstructive pulmonary disease, lung cancer, and emerging post-infectious conditions, and it contributes significantly to disability-adjusted life years globally. This narrative review synthesizes the available literature to critically evaluate the impact of smoking on respiratory health, integrating evidence on conventional cigarette smoking and electronic cigarette use. It examines current trends, highlights unmet clinical and public health needs, and identifies key knowledge gaps to inform future research and tobacco control strategies. The review examines the respiratory effects of tobacco and e-cigarette constituents, including their inflammatory, oxidative, and immunomodulatory mechanisms, and assesses the physiological and clinical benefits of smoking cessation. Current pharmacological and behavioral cessation strategies are reviewed, alongside emerging approaches and public health interventions. Particular attention is given to disparities in respiratory health priorities, healthcare infrastructure, and access to…

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