Smoking-Related Interstitial Lung Diseases

Immunol Allergy Clin North Am. 2023 May;43(2):273-287. doi: 10.1016/j.iac.2023.01.007. Epub 2023 Mar 1.


Smoking-related interstitial lung diseases (ILDs) are a group of heterogeneous, diffuse pulmonary parenchymal disease processes associated with tobacco exposure. These disorders include pulmonary Langerhans cell histiocytosis, respiratory bronchiolitis-associated ILD, desquamative interstitial pneumonia, acute eosinophilic pneumonia, and combined pulmonary fibrosis and emphysema. This review summarizes the current evidence of pathogenesis, clinical manifestations, diagnostic approach, prognosis, and treatment modalities for these diseases. We also discuss the interstitial lung abnormalities incidentally detected in radiologic studies and smoking-related fibrosis identified on lung biopsies.

Keywords: Acute eosinophilic pneumonia; Combined pulmonary fibrosis and emphysema; Desquamative interstitial pneumonia; Pulmonary Langerhans cell histiocytosis; Respiratory bronchiolitis.

Publication types

  • Review

MeSH terms

  • Bronchiolitis* / etiology
  • Bronchiolitis* / pathology
  • Humans
  • Lung / pathology
  • Lung Diseases, Interstitial* / diagnosis
  • Lung Diseases, Interstitial* / etiology
  • Lung Diseases, Interstitial* / therapy
  • Smoking / adverse effects