Cigarette smoke enhances the biofilm index of multiple paranasal sinus isolates
. Eighteen pathogenic bacterial strains were isolated from non-smokers and 16 from smokers with sinonasal mucopurulence and evaluated for biofilm forming capacity after three hour tobacco smoke exposure from five 1R5F reference cigarettes or sham exposure. Data from all strains was then normalized by creating a ratio of smoke to sham exposed biofilm formation. A value of <1 demonstrates biofilm inhibition while a value of >1 reflects biofilm induction. The biofilm index was significantly different between the isolates from smokers and non-smokers (p < 0.001). Data is taken from Goldstein-Daruech et al. .