Evaluating the Influence of Smoking on Sarcoidosis Prognosis: A Comprehensive Retrospective Study

<bold>Introduction:</bold> It has been proposed that smoking tobacco may have a protective effect against sarcoidosis. No recent studies have confirmed these observations, and no studies have assessed the role of smoking in the progression of sarcoidosis and its associated comorbidities. We aim to determine whether smoking affects the progression of sarcoidosis. <bold>Method:</bold> We conducted a retrospective study of 276 patients with sarcoidosis at our hospital, for whom tobacco status was available. Patients were categorised into two groups: exposed to tobacco (active and ex-smokers) and not exposed. Demographics, comorbidities and disease progression were compared between the groups. Data were analysed using IBM SPSS Statistics software. <bold>Results:</bold> From 276 patients, 174 (63%) were non-smokers, 73 (26%) were former smokers and 29 (10%) were active smokers. Exposed to tobacco (n= 102) were more frequently male compared to non-smokers (p=0.002). No differences were observed in age, Scadding classification, extrapulmonary manifestations and use of therapy between both groups. Smoking did not influence functional and radiological pulmonary progression in patients with 5 years follow-up (n=51). Interestingly, oncological diseases were more frequents in exposed to tobacco patients [11 (10.6%)] compared to non-smokers [7 (4%)] (p= 0.04). <bold>Conclusions:</bold> No beneficial effect on sarcoidosis outcomes was observed. Our findings contribute to the growing body of literature that questions the purported protective effects of smoking in sarcoidosis. Further research is needed, looking into the mechanisms by which smoking influences sarcoidosis and highlights the importance of smoking cessation support for patients with sarcoidosis