The role of secondhand smoke in allergic rhinitis: a systematic review

Hur, Kevin; Liang, Jonathan; Lin, Sandra Y.

doi:10.1002/alr.21246

Cited by 21 publications

(16 citation statements)

References 48 publications

(55 reference statements)

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“…Likewise, both active smoking and SHS exposure have shown an association with increased prevalence of chronic rhinosinusitis . In children, significant associations with tobacco smoke exposure have been reported with allergic rhinitis, asthma, bronchitis, and chronic cough . In addition, increasing cotinine levels in children have been shown to be associated with worse pulmonary function test results in a dose‐dependent manner .…”

Section: Discussionmentioning

confidence: 99%

Allergic sensitization, rhinitis, and tobacco smoke exposure in U.S. children and adolescents

Shargorodsky

García‐Esquinas

Navas‐Acien

et al. 2015

Int Forum Allergy Rhinol

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Background Childhood tobacco exposure has been linked with sinonasal pathology, and may be associated with allergic sensitization. This study evaluates the association between exposure to active smoking or secondhand smoke (SHS) and the prevalence of rhinitis and allergic sensitization in the U.S. pediatric population. Methods Cross-sectional study in 2714 children and adolescents aged 6 to 19 in the National Health and Nutrition Examination Survey (NHANES), 2005–2006. Active smoking was defined as self-reported smoking or serum cotinine concentrations >10 ng/mL. SHS was defined as nonactive smokers who reported living with ≥1 smokers or had serum cotinine ≥0.011 ng/mL. Self-reported rhinitis was based on symptoms during the past 12 months, and allergen sensitization was defined as a positive response to any of the 19 specific immunoglobulin E (IgE) antigens tested. Results About half of the population (54%) had detectable levels of IgE specific to at least 1 of the tested allergens, and 25% reported a history of rhinitis. After multivariate adjustment, an increased prevalence rate ratio (PRR) of self-reported rhinitis was seen in individuals in the highest cotinine tertile among active smokers (PRR, 1.73; 95% confidence interval [CI], 1.23 to 2.43), with a significant trend between increasing cotinine levels in individuals exposed to either secondhand smoke or active smoking (p = 0.05 for both analyses). Significantly less food allergen sensitization was observed in participants in the highest cotinine tertile of secondhand smoke (PRR, 0.61; 95% CI, 0.43 to 0.85). Conclusion Tobacco smoke exposure was associated with increased prevalence of rhinitis symptoms, but decreased prevalence of allergic sensitization. The results highlight the complex relationship between tobacco exposure and sinonasal pathology.

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Section: Discussionmentioning

confidence: 99%

Allergic sensitization, rhinitis, and tobacco smoke exposure in U.S. children and adolescents

Shargorodsky

García‐Esquinas

Navas‐Acien

et al. 2015

Int Forum Allergy Rhinol

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“…A recent study conducted by our group 12 has demonstrated a dose-response relationship between tobacco smoke exposure and immunoglobulin E (IgE) sensitization to particular allergens including cockroaches, grass pollens, and certain foods among children in a general population. To date, a few studies have addressed the effects of tobacco smoke exposure on allergic rhinitis in children, though results have been inconsistent [13][14][15][16][17][18][19][20] . The reasons for this inconsistency may be partly explained by differences in extent of tobacco smoke exposure, populations, methods, and sample size.…”

Section: Discussionmentioning

confidence: 99%

“…A majority of previous studies assessed exposure to tobacco smoke using questionnaires rather than using an objective assessment of cotinine levels. In a systematic review of 40 studies investigating the role of secondhand smoke in allergic rhinitis 20 , tobacco smoke exposure was evaluated using a cotinine/creatinine ratio in only 1 study 21 , whereas all other studies used a questionnaire to evaluate tobacco smoke exposure. Montano-Velazquez et al found that tobacco smoke exposure was related to increased nasal resistance among adolescents with allergic rhinitis in Mexico 21 .…”

Section: Discussionmentioning

confidence: 99%

Exposure to Tobacco Smoke and Childhood Rhinitis: A Population-Based Study

Tsai

Yao

Chang

et al. 2017

Journal of Allergy and Clinical Immunology

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Exposure to tobacco smoke has been associated with harmful effects on child health. The association between tobacco smoke exposure and childhood rhinitis has not been established in developed or developing countries. We investigated the association between serum cotinine levels and rhinitis in a population sample of 1,315 Asian children. Serum cotinine levels were positively associated with rhinitis ever (adjusted odds ratio [AOR] = 2.95; 95% confidence interval [CI]: 1.15-7.60) and current rhinitis (AOR = 2.71; 95% CI: 1.07-6.89), while the association for physician-diagnosed rhinitis approaching borderline significance (AOR = 2.26; 95% CI: 0.88-5.83). Stratified analyses demonstrated significant association of serum cotinine levels with current rhinitis among children without allergic sensitization (AOR = 6.76; 95% CI: 1.21-37.74), but not among those with allergic sensitization. Serum cotinine levels were positively associated with rhinitis ever (AOR = 3.34; 95% CI: 1.05-10.61) and current rhinitis (AOR = 4.23; 95% CI: 1.28-13.97) among adolescents but not in children aged less than 10 years. This population-based study demonstrates supportive evidence for positive association of tobacco smoke exposure with rhinitis, while the effect is mainly confined to non-allergic rhinitis and more pronounced in adolescents than in young children, highlighting the need for raising public health awareness about the detrimental effects of tobacco smoke exposure on children's respiratory health.Allergic diseases commonly develop during childhood as a result of interaction between genetic and environmental factors 1 . For several decades, there has been a remarkable increase in prevalence of childhood allergic diseases such as asthma, allergic rhinitis, and atopic dermatitis (eczema), which has reached epidemic numbers in several countries including Taiwan [2][3][4] . Specifically, the prevalence of allergic rhinoconjunctivitis in 6-7-year-old children in Taiwan is among the highest around the world 3 , attracting substantial research and public attention. Changes in lifestyle are thought to be at least partly responsible for the allergy epidemics extending beyond the past few decades 2 . Tobacco use is one of the leading modifiable risk factors for non-communicable diseases 5 . Smoking population has been estimated around 1.3 billion worldwide 6 . It is estimated that approximately one billion people may die due to tobacco-related causes during the twenty-first century 6 . Exposure to environmental tobacco smoke is one of the most common preventable health hazards for children 7 , whose respiratory and immune systems are still growing and defense mechanisms are relatively vulnerable. Using data collected from 192 countries, Oberg et al.report that approximately 40% of children, 33% of men, and 35% of women worldwide are regularly exposed to

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“…Active smoking is associated with increases in markers of systemic inflammation in patients with CRS . Recent systematic reviews have shown significant association between upper respiratory diseases (rhinitis and sinusitis) and passive smoking . Lung function is affected in patients with CRS including active smokers .…”

Section: Discussionmentioning

confidence: 99%