“Effects of Tobacco Smoke on Aeroallergen Sensitization and Clinical Severity among University Students and Staff with Allergic Rhinitis”

Abstract

Allergic diseases, affecting a variety of organs, have continuously increased both in developed and developing countries. Tobacco smoke exposure increases prevalence of allergic rhinitis (AR) and may affect allergic sensitization. This study was designed to compare indoor-aeroallergen sensitization between those not exposed and exposed to tobacco smoke in university students and staff with allergic rhinitis. A cross-sectional descriptive study among university students and staff with allergic rhinitis was performed from February 1, 2018, to March 31, 2019. Questionnaires regarding demography, clinical symptoms, and tobacco smoke exposure were implemented. A current smoker was defined as using, at least, 1 cigarette per day for, at least, 1 month. A secondhand smoker was defined as the one who never smoked, but lived with a current smoker, at least, for 1 month. A skin prick test for eight common indoor aeroallergens, Dermatophagoides pteronyssinus, Dermatophagoides farinae, Periplaneta americana, cat dander, dog dander, para grass, careless weed, and Cladosporium spp., was performed. Sensitization was defined as positivity to, at least, 1 aeroallergen. One hundred and twenty-eight adult patients were eligible participants for the study, and 68 cases (53.10%) were classified as having tobacco smoke exposure. Among these, most of them were secondhand smokers (50 cases, 73.50%). There was no statistically significant difference between exposure and nonexposure to tobacco smoke and indoor aeroallergen sensitization, except for the Periplaneta americana antigen (p=0.013). Most of those in the nonexposure group (34 cases, 56.70%) were classified as having intermittent allergic rhinitis, whereas the tobacco exposure group had significantly more prevalence of severe clinical symptoms. In conclusion, tobacco smoke exposure did not appear to have much influence on aeroallergen sensitization for 7 of the 8 antigens examined. However, for the Periplaneta americana antigen, there was a highly significant correlation with patients experiencing worsened allergic rhinitis symptoms. Overall, it was observed that allergic rhinitis patients exposed to tobacco smoke had more severe clinical symptoms. Future studies should look for other potential antigens of interest, such as mould. Implementation of public health practices reducing exposure to tobacco smoke could have benefits in allergic rhinitis patients.

The Survival Rate of Chick Embryo Influenced by Nicotine and Antioxidant Green Tea (Camellia Sinensis)

“…They have two times more chances in mortality as compared with those who are nonsmoker. 18 Quitting cigarette smoke as a first and secondhand smoker improved health benefits whereas some or all the reduced life expectancy can be improved depending on the age a person quits. 14 Recent research by Kasote et al, showed the antioxidant property of some plants used as therapeutic entities.…”

The Role of Environmental Risk Factors on the Development of Childhood Allergic Rhinitis

“…A meta-analysis found that children actively smoking had an increased risk of AR, while those exposed to second-hand smoke (passive smoking) had a much larger increased risk for AR [6]. In a French epidemiological study, children actively smoking were almost three times more likely to experience symptoms of AR than non-smoking children [19]. Maternal smoking was also found to contribute to AR development in the child.…”

“…Indoor air pollution including tobacco smoke, indoor allergens (e.g., dust mites, pet dander, molds), and other pollutants (e.g., cleaning chemicals) all contribute to the development of AR and the aggravation of symptoms [9]. Individuals in western countries spend the vast majority of their time indoors, and more than 90% of the population live in places where air quality does not meet World Health Organization (WHO) standards, leading to increased rates of AR in children [19]. Furthermore, during the Health Effects of School Environment (HESE) project, it was found that 78% of children attending schools in Norway, Sweden, Denmark, France, and Italy are exposed to high levels of inhalable particulate matter with a diameter of 10 micrograms (PM 10 ), and 66% are exposed to carbon dioxide (CO 2 ) over 1000 ppm [20].…”

“…Small changes in micro-environmental conditions can also affect local microbiota within the respiratory system and promote airway remodeling [18]. Exposure to tobacco smoke may also increase aeroallergen sensitization and exacerbate AR symptoms [19]. A birth cohort study of over 4000 children followed for 16 years found that exposure to secondhand smoke during infancy was associated with a 1.18 increased risk of rhinitis up to 16 years of age, but exposure to secondhand smoke throughout childhood was not associated with the development of rhinitis, suggesting an early window of susceptibility to SHS [29].…”

“…Moreover, the Irish International Study of Asthma and Allergies in Childhood (ISAAC) study found that children ages 13-14 years who were exposed to secondhand smoke were significantly more likely to have symptoms of AR with an adjusted OR 1.35 (95% CI 1.08-1.70) [30]. In a 2020 study of university students and staff, tobacco smoke appeared to increase nasal resistance and worsen inflammation in AR patients [19]. Additionally, another study found that tobacco causes an increase in IL-33, a driver of Th2-oriented cytokines necessary to activate inflammatory cells and regulate immunity [31].…”