Dose-Response Association between Smoking and Atopic Eczema: Results from a Large Cross- Sectional Study in Adolescents

Abstract

Background: Tobacco smoking and exposure to environmental tobacco smoke (ETS) are known risk factors for asthma, but their association with atopic eczema is unclear. Objective: To investigate the association of smoking and exposure to ETS with prevalence of atopic eczema in a national sample of 13- to 14-year-olds in Israel. Methods: Cross-sectional study within the framework of the International Study on Asthma and Allergies in Childhood. Results: Complete data were available for 10,298 schoolchildren. Atopic eczema as well as asthma and allergic rhinitis were significantly more prevalent in smokers than nonsmokers. Multiple regression analysis revealed a dose-response association between smoking and atopic eczema compared to not smoking: occasional smokers, odds ratio (OR) = 1.6 (95% confidence interval (CI) = 1.2-2.3); daily smokers, OR = 2.2 (95% CI = 1.4-3.6). Exposure to ETS at home was significantly associated with asthma (OR = 1.25; 95% CI = 1.1-1.5) but not atopic eczema. Conclusions: The dose-response association between active smoking and atopic eczema in adolescents is a novel observation which deserves further consideration.

Adolescent versus parent reports on asthma and asthma symptoms

“…However, based on parental reports, the prevalence was higher among Jews, though without statistical significance (5.5% vs. 3.9%). This finding supports a recent study that showed increasing rates among Arabs and stable rates among Jews …”

“…The main limitation of the present study was the absence of an objective measure of asthma. Nonetheless, the validity of the adolescents’ reports is supported by their similarity to results obtained in our 2008 and 2009 studies, which interviewed adolescents of a similar population …”

Environmental tobacco smoke and the risk of eczema symptoms among school children in South Africa: a cross-sectional study

“…Eczema (or atopic dermatitis, AD) is a chronic, and the most frequent, inflammatory skin disease; it usually develops in childhood and can persist through to adulthood. 1 It is characterised by dry skin, itchy rash and excoriation, 2 3 and the condition affects 15–30% of children and 2–10% of adults. 3 The term eczema describes skin diseases with common clinical characteristics involving a genetically determined skin-barrier defect.…”

Association of atopic dermatitis with smoking: A systematic review and meta-analysis

“…In random-effects models, AD was associated with active smoking (OR 1.87, 95% confidence interval [CI] 1.32-2.63) ( Only 2 studies stratified AD prevalence by the amount of active smoking. 22,23 AD was significantly associated with both mild (OR 2.68, 95% CI 1.78-4.04) and extensive (OR 2.70, 95% CI 1.11-6.60) amounts of active smoking with similar effect sizes. No studies examined the relationship between AD severity and active smoking.…”