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Exposure to cigarette smoke associated with increased atopic dermatitis prevalence
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Active smoking and passive tobacco smoke exposure were significantly associated with increased prevalence of atopic dermatitis in children and adults, according to recently published study results.
Jonathan I. Silverberg, MD, PhD, MPH, of the department of dermatology, Northwestern University Feinberg School of Medicine, and colleagues evaluated associations between atopic dermatitis and tobacco smoke exposure by performing a systematic review and meta-analysis. They searched PubMed, EMBASE, Scopus and the Cochrane Library through 2015 for the terms “smoking,” “cigarette,” nicotine,” and “tobacco.”
They identified 86 studies reporting the relationship between atopic dermatitis and smoke exposure, which were included in the review. Random-effects models were used for meta-analysis. Different ages, regions, study designs, study sizes, study quality and amount of smoking were included in subset analyses.
The studies were published from 1989 to 2015 and included 680,176 patients from 39 countries. The study participants included 598,296 children and 67,501 adults, and14,379 nonspecified children or adults. Almost 10% of the patients (n = 65,173) had atopic dermatitis.
There were higher odds of atopic dermatitis with active smoking (OR = 1.87; 95% CI, 1.32-2.63), exposure to passive smoke (OR = 1.18; 95% CI, 1.01-1.38); however, there was not a significant association between atopic dermatitis and maternal smoking during pregnancy (OR = 1.06; 95% CI, 0.8-1.4).
‘The association between active smoking and [atopic dermatitis] remained significant in children and adults, all continents studied, and study sizes, but all were cross-sectional designs and had [Newcastle-Ottawa Scale] score 6 or greater,” the researchers reported.
Cross-sectional studies, South/Central American and African studies, study size less than 5,000 participants and studies with Newcastle-Ottawa Scale of less than 6 reported an association between passive smoke and atopic dermatitis.
“Future studies are needed to address knowledge gaps in the association of smoking and [atopic dermatitis], including studies using objective measures of [atopic dermatitis] severity such as the Eczema Area and Severity Index, objective measures of smoke exposure, more longitudinal studies to determine the temporal relationship between smoking and [atopic dermatitis], and studies to explore the mechanisms of association.” – by Bruce Thiel
Disclosure: The researchers report no relevant financial disclosures.