[What is the contribution of smoking to the increased risk of suicide in young smokers? A systematic review]. / Quelle est la part du tabagisme dans l'augmentation du risque suicidaire chez les jeunes fumeurs ? Revue systématique.

OBJECTIVES: The correlation between smoking and suicide is well documented in the general population: there is an increased risk of suicide among tobacco smokers. However, the association between smoking and suicidal behaviors (ideations, plans, attempts) in youth is poorly elucidated. This is a systematic review of the literature examined data on the relationship between active and passive smoking and suicidal ideation (SI), suicide planning (SP), and suicide attempts (SA) among youth in the general population. METHOD: Medline searches were performed for the period 1980-2020. Cross-sectional, case-control, prospective population-based studies of young people (age less than 18 years) were included in this review; studies of specific populations (patients with an identified pathology of any kind) were excluded. RESULTS: This review included 43 studies: 23 studies on the association between active smoking and SI, SI and/or PS, TS; three studies on the association between passive smoking and suicidal behavior, three studies on the association between smoking and suicidal behavior in young people in psychiatric hospital settings, and five studies comparing the suicidal behavior of girls and boys. Analysis of the data collected lead to the conclusion that active or passive smoking is associated with suicidal behavior in young people. Smoking appears to contribute to psychopathological disorders, including depression, the use of other psychoactive substances, or psychosocial suffering which are often associated with an increased risk of suicide in young people. The correlations between smoking and the presence of mental disorders have been highlighted; tobacco use may contribute to the development of depression, anxiety and stress. Further studies are needed to verify the existence of a causal link between smoking and suicide. CONCLUSION: Smoking is associated with the risk of suicidal behavior in young people; it should be included among the criteria for assessing suicidal risk in youth. Smoking cessation, which improves psychological well-being, should be further integrated into the prevention of suicidal behavior.

[Contribution of electronic cigarettes in smoking patients with psychotic disorders. A literature review]. / Cigarette électronique chez les patients fumeurs présentant une pathologie psychotique. Revue de la littérature.

OBJECTIVES: This systematic literature review focused on patients suffering from schizophrenia (SZ), psychotic disorders or mental illness (MI) including SZ. It was interested in data on prevalence of electronic cigarette (EC) use, patient perceptions and expectations, as well as caregivers' attitudes towards the EC and its benefit in helping to stop or reduce smoking. METHOD: The research was carried out on Medline for the period 2000-2020. Cross-sectional, case-control, prospective, randomized controlled studies and preliminary studies were included in this review. RESULTS: EC is widely used by MI patients with current and lifetime use from 7.4% to 28.6%. More specifically, patients with SZ and schizoaffective disorders observe current and lifetime use from 7% to 36%, respectively. Many reasons are given by patients for its use including the possibility of using it in places where smoking is prohibited, its lower toxicity compared to cigarettes for oneself and those around, its lower cost, and the help provided to reduce consumption. CONCLUSION: EC is used by smokers with MI; several studies confirm the possibility for these smokers to reduce tobacco consumption through EC and without disturbing their mental state. However, its value in helping to quit smoking remains uncertain.

[Tobacco and cannabis consumption : toxicity and management of quitting]. / Consommation de tabac et de cannabis : effets toxiques et prise en charge de l'arrêt.

The use of cannabis is most often associated with that of tobacco. While the addictive power of cannabis is low, that of tobacco is high. The regular use of both tobacco and cannabis is at the origin of the increase in dependence on each substance, which makes stopping this double consumption often difficult. This combined use can cause somatic and mental complications. Practitioners should identify this dual use, advise stopping and offer their help after a careful evaluation of both consumptions and their causes. The management includes psychotherapeutic support; If the efficacy of medications to aid stopping cannabis has not been proven to aid in stopping cannabis, nicotine replacement therapy can limit withdrawal syndrome, craving and improve patients' adherence to monitoring.The mobilization of practitioners in the management of patients and the development of effective cannabis cessation pharmacotherapies are essential.

L'usage du cannabis est le plus souvent associé à celui du tabac. Si le pouvoir addictif du cannabis est faible, celui du tabac est élevé. L'usage régulier de tabac et de cannabis est à l'origine du renforcement de la dépendance à chaque substance, ce qui rend l'arrêt de cette double consommation souvent difficile. Ce double usage peut également être à l'origine de complications somatiques et psychiques. Les praticiens doivent le repérer, conseiller l'arrêt et proposer leur aide à cette fin après avoir fait le bilan des consommations et de leurs causes. La prise en charge comprend un soutien psychothérapeutique; si aucun médicament d'aide à l'arrêt du cannabis n'a fait ses preuves d'efficacité, la substitution nicotinique permet de limiter le syndrome de sevrage, le craving et d'améliorer l'adhérence des patients au suivi thérapeutique. La mobilisation des praticiens dans la prise en charge des patients et la mise au point de pharmacothérapies de sevrage du cannabis efficaces s'imposent.

Effectiveness of Omalizumab in Severe Allergic Asthma and Nasal Polyposis: A Real-Life Study.

BACKGROUND AND OBJECTIVE: Omalizumab is a human anti-IgE antibody approved for the treatment of severe allergic asthma (SAA). However, its effectiveness in SAA associated with chronic rhinosinusitis with nasal polyposis (CRSNP+) is less well documented. Objective: The aim of this study was to evaluate the real-life effectiveness of omalizumab in patients with SAA and CRSNP+ who tolerated and did not tolerate aspirin. METHODS: We performed a retrospective, observational, multicenter, real-life study of patients with SAA and CRSNP+ treated with omalizumab for 6 months. Asthma outcome parameters (symptoms, number of salbutamol rescues/wk, number of moderate/severe exacerbations, Asthma Control Test score, and lung function), sinonasal outcome parameters (symptoms, number of episodes of acute rhinosinusitis, sinus computed tomography images, nasal polyps endoscopy score), and serum eosinophil levels were analyzed 6 months before and after treatment with omalizumab. RESULTS: Twenty-four adult patients were included (9 with documented aspirin intolerance). All respiratory parameters were significantly improved by the treatment. In parallel, a significant improvement was observed in sinonasal clinical outcomes and sinus computed tomography images, with no major effect on the nasal polyps endoscopy score. The serum eosinophil count decreased significantly after 6 months of treatment with omalizumab. CONCLUSION: Treatment of SAA with omalizumab improves the outcome of associated CRSNP+, thus supporting the concept of a "one airway disease".

[Electronic cigarette use in patients with asthma]. / Usage de la cigarette électronique chez le patient asthmatique.

The proportion of patients whose asthma is poorly controlled due to their smoking remains high. Electronic cigarette (EC) is a new tool to help people stopping smoking, which substitutes a much less irritating aerosol to very toxic cigarette smoke, but it cannot be considered completely healthy. It represents a possible assistance for asthmatic smokers who wish using it to stop smoking. This article is a systematic review of the literature on the data concerning the relationships between EC use and asthma. There is a positive association between asthma symptoms, their severity and current use of CE in adolescents. The results are more contrasted in adult asthmatic CE users compared to cigarette smoking. CE should not be used by adolescents but can help, in exclusively use, adults with asthma stopping smoking.

La proportion de patients dont l'asthme est mal contrôlé du fait de leur tabagisme demeure élevée. La cigarette électronique (CE) est un nouveau moyen d'aide à l'arrêt du tabac qui substitue, à la fumée de cigarette très toxique, l'inhalation d'un aérosol beaucoup moins irritant mais elle ne peut pas être considérée comme parfaitement saine. Elle est un recours possible pour les asthmatiques fumeurs qui souhaite l'utiliser pour arrêter le tabac. Cet article réalise une revue systématique de la littérature sur les données concernant les relations entre l'usage de la CE et l'asthme. Il existe une association positive entre les symptômes d'asthme, leur sévérité et l'usage actuel de la CE chez les adolescents. Les résultats sont plus contrastés chez les adultes asthmatiques usagers de la CE comparativement à l'usage de la cigarette. La CE ne doit pas être utilisée par les adolescents mais peut aider, en usage exclusif, les adultes asthmatiques à arrêter de fumer.

[Strategy and stopping smoking interventions in smokers with tuberculosis]. / Stratégie et modalités d'aide à l'arrêt du tabac chez les fumeurs tuberculeux.

Tuberculosis (TB) and smoking are causing a heavy mortality worldwide. Tobacco smoke increases the risk of Mycobacterium tuberculosis infection and tuberculosis disease, including severe pulmonary tuberculosis, resistant bacilli forms and death from this disease. Smoking patients with TB have poorer compliance with treatment of tuberculosis than non-smokers. In countries with high TB incidence and smoking prevalence tending to increase, smoking cessation is a means of controlling the TB epidemic. Stopping smoking improves the course of tuberculosis and promotes its final cure, it is accompanied by a better therapeutic observance. WHO recommended coordination between national tuberculosis and tobacco control programs to optimize control of the TB epidemic. The mobilization of health professionals in helping smokers with tuberculosis stopping smoking is required.

La tuberculose et le tabagisme sont à l'origine d'une lourde mortalité dans le monde. La fumée du tabac augmente les risques d'infection à Mycobacterium tuberculosis et de tuberculose active, appelée tuberculose-maladie (TM) dont le risque de tuberculoses pulmonaires sévères, à bacilles résistants et des décès dus à cette maladie. Les patients fumeurs atteints de tuberculose ont une moins bonne observance du traitement antituberculeux que les non-fumeurs. Dans les pays à forte incidence de tuberculose où la prévalence du tabagisme tend à augmenter, l'arrêt du tabac représente un moyen de contrôle de l'épidémie de tuberculose. L'arrêt du tabac améliore le cours de la tuberculose et favorise sa guérison définitive; il s'accompagne d'une meilleure observance thérapeutique. L'OMS a recommandé une coordination entre les programmes nationaux de lutte antituberculeuse et antitabac pour optimiser le contrôle de l'épidémie de tuberculose. La mobilisation des professionnels de santé dans l'aide à l'arrêt des fumeurs atteints de tuberculose est requise.

[Stopping and reducing smoking in patients with schizophrenia]. / Arrêt et réduction du tabac chez le patient souffrant de schizophrénie.

OBJECTIVES: This systematic review of the literature looked at data on pharmacological and non-pharmacological strategies of smoking cessation and reduction of consumption in patients with schizophrenia. METHOD: The research was conducted on Medline for the period 1980-2018. We included randomized controlled trials, including preliminary studies of stable schizophrenic patients with no other severe psychiatric disorder and no other substance use than tobacco, treated with antipsychotic medications. Individual or group smoking cessation programs with or without pharmacological treatment, including a validation of abstinence, were included. RESULTS: Pharmacotherapies for nicotine dependence-nicotine replacement therapy (n=3), bupropion (n=6), varenicline (n=8), association of medications (n=4)-were used in 23 studies combined with behavioral support. Compared to the placebo, bupropion and varenicline at the end of treatment were found to be the most effective pharmacotherapies to stop or reduce smoking and control craving. All the medications were well tolerated and did not lead to aggravation of psychosis or changes in symptoms. Non-pharmacological interventions: behavioral and cognitive therapies (n=5) combined with pharmacological treatment facilitated the management of smoking risk situations and improved adherence to antipsychotics; other psychosocial interventions (n=7) allowed the development of social skills; contigency management strategies with financial reinforcement can be used (n=4); the practice of physical activity and the use of an electronic cigarette allowed reduction of tobacco consumption. The results of transcranial electromagnetic stimulation studies (n=6) were discordant. Atypical antipsychotics appear to be associated with a better success of attempts to stop smoking. CONCLUSION: Smoking cessation strategies for patients with schizophrenia appear to be effective and should combine (1) smoking cessation medications with sufficient duration, (2) diversified psychosocial approaches and (3) physical activity practice.

[Why stopping smoking is difficult in patients suffering from schizophrenia? How better to take care of them?] / Pourquoi l'arrêt du tabac est-il difficile pour les fumeurs souffrant de schizophrénie ? Comment mieux les prendre en charge ?

Smoking is much higher among patients suffering from schizophrenia compared to the general population. These patients inhale the smoke more deeply and extract a significant amount of nicotine from the cigarette. They are highly addicted to tobacco and their attempts to stop smoking are more frequently marked by failures. The continuation of consumption exposes them particularly to the risk of diseases and mortality related to smoking. Various hypotheses are advanced to explain the association between schizophrenia and tobacco smoking. Tobacco smoke and/or nicotine appear to compensate for certain cognitive deficits due to the disease or to correct adverse events of anti-psychotics. Furthermore, genetic factors, personality traits and socio-cultural factors appear to be jointly implicated in mental illness and smoking. Smoking cessation, which does not aggravate schizophrenia, combines psycho-social approaches and medication treatments; it can be helped by the use of the electronic cigarette and the practice of physical exercise. Professionals must ensure long-term personalized follow-up.

La consommation de tabac est beaucoup plus élevée parmi les patients souffrant de schizophrénie comparativement à la population générale. Ces patients inhalent plus profondément la fumée et extraient une importante quantité de nicotine de la cigarette. Ils présentent une forte dépendance tabagique et leurs tentatives d'arrêt du tabac sont plus fréquemment marquées par des échecs. La poursuite de la consommation les expose particulièrement au risque de maladies et de mortalité en lien avec le tabagisme. Diverses hypothèses sont avancées pour expliquer l'association entre la schizophrénie et le tabagisme : le tabagisme et/ou la nicotine paraissent compenser certains déficits cognitifs dus à la maladie ou corriger des événements indésirables des anti-psychotiques. De plus, des facteurs génétiques, des traits de personnalité et des facteurs sociaux culturels paraissent conjointement impliqués dans la maladie mentale et l'usage du tabac. Le sevrage tabagique qui n'aggrave pas la maladie associe les prises en charge psycho-sociales et les médicaments d'aide à l'arrêt; il peut être aidé par l'usage de la cigarette électronique et la pratique de l'exercice physique. Les professionnels doivent assurer un suivi personnalisé de longue durée.

[Smoking cessation treatment for smokers with COPD: The importance of therapeutic education]. / Sevrage tabagique du patient atteint de BPCO : importance de l'éducation thérapeutique.

Smoking is a major risk factor for chronic obstructive pulmonary disease (COPD). The diagnosis of tobacco addiction and management of tobacco dependence are part and parcel of COPD treatment, especially in respiratory rehabilitation. Management encompasses psychological support, validated treatments and therapeutic education. The objective of this review is to briefly recall the guiding principles of therapeutic patient education (TPE) as it applies to smokers wishing to quit and, more specifically, to present the tools conducive to shared educational assessment and treatment according to the Prochaska's stages of change model. We are also proposing an action plan and a questionnaire through which TPE sessions can be assessed. Finally, culturally adapted interventions and new communication technologies are taken into consideration insofar as they constructively contribute to TPE.

[Diffuse alveolar hemorrhage in cannabis smokers. A systematic literature review]. / Hémorragies alvéolaires diffuses chez les fumeurs de cannabis. Revue systématique.

Cannabis is the most widely used illicit psychoactive substance in France. It can be responsible for numerous pulmonary complications, including diffuse alveolar hemorrhage (DAH). The objective of this systematic review of the literature was to present data concerning the relationship between cannabis smoking and DAH, which has rarely been reported in the literature. The review was based on a Medline search covering the 1980-2022 period and utilizing data drawn from 10 articles. DAH diagnosis is based on an association of hemoptysis, anemia and diffuse alveolar opacities on chest radiography with siderophages in the Bronchoalveolar Lavage Fluid (BAL). The 11 patients identified in this review were daily or regular cannabis smokers; in 4 cases they presented recent or recurrent hemoptysis with anemia; imaging revealed diffuse alveolar opacities in 10 of them, while BAL endoscopy highlighted a diffuse hemorrhage in the bronchial tree, and siderophages were observed in 6 cases. While evolution was favorable when cannabis consumption was discontinued, resumption occasioned DAH recurrence, and one patient died. Advice to quit should systematically be accompanied by addictological follow-up.

[Bronchial diseases and heroin use. A systematic review]. / Pathologies bronchiques et usage d'héroïne. Revue systématique.

INTRODUCTION: Heroin use can cause respiratory complications including asthma, chronic obstructive pulmonary disease (COPD) and bronchiectasis (BD). OBJECTIVES: A general review of the literature presenting the data on the relationships between heroin consumption and bronchial complications, while underlining the difficulties of diagnosis and management. DOCUMENTARY SOURCES: Medline, 1980-2022, keywords "asthma" or "bronchospasm" or "COPD" or "bronchiectasis" and "heroin" or "opiate" or "opiates", with limits pertaining to "Title/Abstract". Concerning asthma, 26 studies were included, as were 16 for COPD and 5 for BD. RESULTS: Asthma and COPD are more prevalent among heroin addicts, who are less compliant than other patients with their treatment. The authors found a positive association between frequency of asthma exacerbations, admission to intensive care and heroin inhalation. Late diagnosis of COPD worsens the course of the disease; emphysema and BD are poor prognostic factors. CONCLUSION: Bronchial diseases in heroin users can be identified by means of respiratory function exploration and chest CT scans. These tests should be performed frequently in view of optimizing their care, which includes their weaning themselves from addictive substances.

[Asthma and suicidal behavior in adolescents: a literature review]. / Asthme et comportements suicidaires chez les adolescents: revue systématique.

INTRODUCTION: Adolescence is a difficult time in life and asthma has major psychological consequences for adolescents. OBJECTIVES: This systematic literature review focused on the association between asthma and suicidal behaviors (suicidal ideations [SI], suicide plans [SP] and suicide attempts [SA]) among adolescents in the general population. METHOD: Research on Medline for the 1980-2021 period. Objectives This systematic literature review focused on the association between asthma and suicidal behaviors (suicidal ideations [SI], suicide plans [SP] and suicide attempts [SA]) among adolescents in the general population. RESULTS: An overwhelming majority of the studies taken into consideration demonstrated a significant positive association between asthma and suicidal behaviors. Among the 10 studies assessing SI (with or without SP), 9 of them found a significant positive association between asthma and SI. Eight studies assessed SA; five cross-sectional studies and one prospective study demonstrated a significant positive association between asthma and SA. Only one case-control study did not find a significant positive association between asthma and SA after hospitalization for asthma. The two cross-sectional studies assessing suicidal risk taken as a whole (SI, SP and SA) demonstrated a significant positive association between asthma and at least one suicidal behavior. (OR=1.71; P<0.001). However, several studies did not include depression as an adjustment factor. CONCLUSION: It is important that healthcare professionals assess suicide risk in adolescent suffering from asthma, the objective being to avoid SA or death from SA.

[Inhaled marijuana and the lung, a toxic cocktail?] / Cannabis inhalé et poumon, une liaison dangereuse ?

Unlike the well-documented effects of tobacco smoke on the lung, the effects of cannabis smoke remain controversial, the main bias consisting in co-consumption of tobacco. That said, the composition of joint smoke is close to that of cigarettes, containing many compounds that are carcinogenic and/or alter the respiratory epithelium. Confirmed respiratory effects in chronic cannabis smokers include aggravated chronic bronchitis symptoms, a cumulative effect with tobacco on COPD and emphysema occurrence, an increased risk of bullous emphysema, and pneumothorax with heightened risk of recurrence after pleural symphysis. Recent prospective studies have shown a negative impact on lung function, with not only damage to the airways, but also DLCO alteration and an accelerated drop in FEV1. Finally, cannabis smoking is very common among young patients with lung cancer. Its consumption could lead to a different lung cancer profile, potentially more undifferentiated and less accessible to targeted therapy. Questioning about cannabis consumption must be systematic and targeted medical care should be offered.

[COPD, anxiety-depression and cognitive disorders: Does inflammation play a major role?] / BPCO, troubles anxio-dépressifs et cognitifs : l'inflammation joue-t-elle un rôle prépondérant ?

COPD is a chronic respiratory disease, often associated with extrapulmonary manifestations. Co-morbidities, including anxiety, depression and cognitive impairment, worsen its progression and quality of life. The prevalence of these disorders is high, yet they are often poorly understood and inadequately managed. In the development of psychological disorders, there is accumulated evidence highlighting the major role of systemic inflammation, as well as chronic disease, genetics, the consequences of smoking, hypoxaemia, oxidative stress, and the gut microbiome In addition to traditional treatments such as bronchodilatator medications, respiratory rehabilitation and smoking cessation, systemic inflammation is an interesting therapeutic target, with the use of anti-inflammatory drugs, anti-cytokines, and nutritional interventions.

[Smoking cessation in smokers with pulmonary Langerhans cell histiocytosis - considerations from the management of ten patients]. / Sevrage tabagique de fumeurs souffrant d'histiocytose pulmonaire langerhansienne. Réflexions issues de la prise en charge de dix patients.

Pulmonary Langerhans cell histiocytosis (PLCH) belongs to the spectrum of diffuse interstitial cystic pneumonias; it affects young people of both sexes and occurs almost exclusively in tobacco smokers or co-users of tobacco and cannabis. The management of this severe chronic disease is undertaken in specialized centers. A better understanding of the pathogenic mechanisms of the disease has opened up prospects for targeted therapies. However, supporting the abstinence from inhaling noxious materials which determine its prognosis remains the cornerstone of treatment. Patients with PLCH who persist in smoking despite the diagnosis may be very dependent on tobacco, experience significant difficulties in stopping smoking, and must have access to specialist smoking cessation clinics.

[Smoking cessation in asthmatic patients and its impact]. / Spécificité du sevrage tabagique chez l'asthmatique et effets du sevrage sur l'asthme.

INTRODUCTION: The prevalence of smoking in asthmatic patients is similar to, or even higher than in the general population. OBJECTIVES: This systematic review addresses (1) the effects of smoking on asthma, (2) smoking cessation strategies in asthmatic patients, and (3) the consequences of smoking cessation for people with asthma. RESULTS: Active or passive smoking can promote the development of asthma. The few studies on smoking cessation in asthma confirm the efficacy of validated smoking cessation strategies in these patients (nicotine replacement therapy, varenicline, bupropion, cognitive and behavioural therapies). Smoking cessation in parents with asthmatic children is essential and is based on the same strategies. Electronic cigarettes may be a useful help to quit smoking in some patients. Smoking cessation is beneficial in asthmatic smokers and associated with (1) a reduction of asthma symptoms, acute exacerbations, bronchial hyperresponsiveness, and bronchial inflammation, (2) decreased use of rescue medications and in doses of inhaled corticosteroids, (3) improved asthma control, quality of life, and lung function. CONCLUSION: In asthmatic patients, it is essential to assess smoking status and health professionals must assist them to quit smoking.

[Combinations of pharmacological treatments in smoking cessation. A systematic review]. / Combinaisons des traitements pharmacologiques au cours du sevrage tabagique. Revue systématique.

INTRODUCTION: The effectiveness of the three validated smoking cessation medications, nicotine replacement therapy, varenicline and bupropion, may be insufficient, in hard-core smokers. OBJECTIVES: This systematic review investigates the efficacy of combinations of different medications in smoking abstinence and their tolerability. RESULTS: Three randomized controlled trials (RCTs) compared the combined medications with varenicline and nicotine patches vs. varenicline; two found an increase in abstinence rates with the combined medications. In one study, the beneficial effect was only observed in heavy smokers. The four RCTs comparing the combined medications with varenicline and bupropion (vs. varenicline) demonstrated an increase in abstinence rates with the combined medications, most often in heavy smokers who are very dependent on tobacco. The results of the three RCTs comparing the combined medications with bupropion and nicotine replacement therapy vs. varenicline were discordant. Three studies included other molecules (mecamylamine, selegiline, sertraline, buspirone). Combined medications were well tolerated. CONCLUSION: Combination treatments can achieve higher smoking abstinence rates than monotherapies, especially in smokers who have failed to quit (Hard-core smokers). Treatment with a combination of varenicline and nicotine replacement therapy is a therapeutic option in smoking cessation.

[Pulmonary complications in cocaine users]. / Complications pulmonaires chez les consommateurs de cocaïne.

Cocaine can be responsible for many psychiatric and/or somatic disorders. The aim of this systematic literature review of data was to expose relations between cocaine use and pulmonary complications. Cocaine can be responsible for acute respiratory symptoms (cough, black sputum, hemoptysis, dyspnea, wheezing, chest pain) and for various pulmonary disorders including barotrauma (pneumothorax, pneumomediastinum, subcutaneous emphysema, pneumopericardium), airway damage, asthma, bronchiolitis obliterans with organizing pneumonia, acute pulmonary edema, alveolar hemorrhage, alveolar pneumonia with carbonaceous material, bullous emphysema, acute eosinophilic pneumonia, pulmonary granulomatosis caused by talc or cellulose, interstitial pneumonitis and pulmonary fibrosis, vasculitis, pulmonary hypertension, pulmonary embolism and pulmonary infarction, mycotic pulmonary arterial aneurysms, septic emboli, aspiration pneumonia, community-acquired pneumonia, HIV-related opportunistic infections, latent tuberculosis infection, pulmonary tuberculosis, lung cancer and crack lung. Some of these complications are serious and may have a fatal outcome. Pulmonary function tests, thoracic tomodensitometry, bronchial fibroscopy with bronchoalveolar lavage and lung scintigraphy may be an aid to the diagnosis of these pulmonary compications. Cocaine use must be sought in case of respiratory symptoms in young persons.

[Asthma and cannabis, cocaine or heroin use]. / Asthme et usage de cannabis, de cocaïne ou d'héroïne.

INTRODUCTION: The use of cannabis, cocaine or heroin can be responsible for many respiratory complications including asthma. OBJECTIVES: The aim of this systematic literature review of data was to expose the relations between cannabis, cocaine or heroin use and asthma. RESULTS: Cannabis, cocaine or heroin use by inhalation may be responsible for respiratory symptoms (cough, wheezing), asthma onset, acute asthma exacerbations (which may require intubation and invasive ventilation) or deaths related to asthma. Lower adherence to asthma treatment is also observed. Cannabis induces a rapid bronchodilator effect. In contrast, its chronic use may induce a decrease in specific airway conductance. Studies on forced expiratory volume in one second (FEV1) reduction or decline are discordant. CONCLUSION: Cannabis, cocaine or heroin use must be considered in cases of acute respiratory symptoms or asthma exacerbation in young persons and practitioners must help illicit substance users to stop their consumption.

[Acute eosinophilic pneumonia and illicit psychoactive substance use]. / Pneumonies aiguës à éosinophiles et usage de substances psychoactives illicites.

Illicit psychoactive substance (IPAS) use can lead to a number of respiratory complications, including acute eosinophilic pneumonia (AEP). Systematic literature review of data on AEP in IPAS users (cannabis, cocaine, heroin and amphetamine). Of two cases of cannabis and tobacco users reported to have developed AEP, one, a teenage15 year old boy presented with acute respiratory distress syndrome (ARSD) which necessitated extracorporeal membrane oxygenation (ECMO). Five cases of AEP in cocaine smokers (crack) are reported, one of which was fatal. The patient presented with acute pulmonary edema and ARDS which progressed to ventricular fibrillation and asystole. A 24-year-old woman presented with AEP after repeated inhalation of heroin. Finally, a case of an amphetamine abuser who developed AEP and ARDS after amphetamine inhalation is reported. The time between the first IPAS use and admission in cases reported ranged from 7 days to 4 years, while time between the last IPAS use and admission was short (less than 15 days). IPAS use must be sought in case of AEP, especially in young adults, and practitioners must advise and help users to stop their consumption.