Intermittent or Continuous Acetylsalicylic Acid and Gene Expression in the Nasal Tissue of Current Smokers

Inclusion Criteria:

* Male or female current tobacco smokers with \>= 20 pack years of self-reported smoking exposure and an average use of \>= 10 cigarettes/day
* Karnofsky \>= 70%
* Leukocytes \>= 3,000/microliter
* Absolute neutrophil count \>= 1,500/microliter
* Hematocrit within normal institutional limits
* Platelets within normal institutional limits
* Total bilirubin =\< 1.5 × institutional upper limit of normal (ULN)
* Aspartate aminotransferase (AST) (serum glutamic oxaloacetic transaminase \[SGOT\])/alanine aminotransferase (ALT) (serum glutamate pyruvate transaminase \[SGPT\]) =\< 1.5 × institutional ULN
* Creatinine =\< the upper institutional limits
* Prothrombin time (PT)/partial thromboplastin time (PTT) within normal institutional limits
* Fertile subjects must use adequate contraception (abstinence, barrier methods, or birth control pills) prior to study entry and for the duration of study participation
* Participants may have a history of indeterminate pulmonary nodule(s) by chest imaging if nodule follow-up has been completed or the study procedures would not interfere with nodule follow-up
* Ability to understand and the willingness to sign a written informed consent document

Exclusion Criteria:

* History of allergic reaction to aspirin or attributed to compounds of similar chemical or biologic composition to aspirin, including other nonsteroidal anti-inflammatory drugs (NSAIDs)
* Gastric intolerance attributable to ASA or NSAIDs
* History of gastric ulcer within the past 5 years (with or without bleeding)
* Use of ASA or NSAIDs for more than 5 days per month within 3 months of enrollment
* Not willing or are unable to refrain from use of any non-study ASA or NSAIDs during the study period
* Adult asthma
* Chronic, current or recent (within the past three months) use of leukotriene antagonists
* Require chronic anticoagulation or anti-platelet therapy
* History of bleeding disorder or hemorrhagic stroke
* Chronic, current or recent (within the past three months) use of glucocorticoids (systemic, topical and/or nasal sprays)
* History of chronic sinusitis or recent nasal polyps
* Not willing or are unable to limit alcohol consumption to =\< 2 alcoholic beverages a day during the study period
* Pregnant or lactating women; breastfeeding should be discontinued if the mother is treated with aspirin; should a woman become pregnant or suspect she is pregnant while participating in this study, she should inform her study physician immediately
* Participants may not be receiving any other investigational agents
* Uncontrolled intercurrent illness including, but not limited to, ongoing or active infection, symptomatic congestive heart failure, unstable angina pectoris, cardiac arrhythmia, or psychiatric illness/social situations that would limit compliance with study requirements
* Have a known history of inability to absorb an oral agent
* Invasive cancer within the past five years except non-melanoma skin cancer
* Urine cotinine level, if collected at screening, does not confirm active smoking status