TY - JOUR
T1 - Association of atopic dermatitis with smoking
T2 - A systematic review and meta-analysis
AU - Kantor, Robert
AU - Kim, Ashley
AU - Thyssen, Jacob P.
AU - Silverberg, Jonathan I.
N1 - Funding Information:
This publication was made possible with support from the Agency for Healthcare Research and Quality, grant number K12HS023011, and the Dermatology Foundation. No honorarium, grant, or other form of individual payment was given to anyone to produce the manuscript.
Publisher Copyright:
© 2016 American Academy of Dermatology, Inc.
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Background Tobacco exposure might be a modifiable risk factor for atopic dermatitis (AD). Objective We examine the association between AD and exposure to tobacco smoke. Methods We performed a systematic review and meta-analysis of observational studies (n = 86) in MEDLINE, EMBASE, Scopus, and Cochrane Library (1823-2015). Quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS). A meta-analysis was performed using random-effects models to estimate pooled odds ratios (OR). Subset analyses were performed for different ages (children, adult), regions, study designs (cross-sectional, longitudinal), study sizes (<5000, ≥5000), study quality (NOS score <6, ≥6), and amount of smoking (mild, extensive). Results A diagnosis of AD was associated with higher odds of active smoking (OR 1.87, 95% confidence interval 1.32-2.63) and exposure to passive smoke (OR 1.18, 95% confidence interval 1.01-1.38), but not maternal smoking during pregnancy (OR 1.06, 95% confidence interval 0.80-1.40). The association between active smoking and AD remained significant in children and adults, all continents studied, and study sizes, but all were cross-sectional designs and had NOS score 6 or greater. Passive smoke was associated with AD in children and adults, cross-sectional studies, South/Central American and African studies, study size less than 5000, and NOS score less than 6. Limitations AD severity and distribution were not assessed. Conclusions Active and passive exposure to smoke are associated with increased AD prevalence.
AB - Background Tobacco exposure might be a modifiable risk factor for atopic dermatitis (AD). Objective We examine the association between AD and exposure to tobacco smoke. Methods We performed a systematic review and meta-analysis of observational studies (n = 86) in MEDLINE, EMBASE, Scopus, and Cochrane Library (1823-2015). Quality of evidence was assessed using the Newcastle-Ottawa Scale (NOS). A meta-analysis was performed using random-effects models to estimate pooled odds ratios (OR). Subset analyses were performed for different ages (children, adult), regions, study designs (cross-sectional, longitudinal), study sizes (<5000, ≥5000), study quality (NOS score <6, ≥6), and amount of smoking (mild, extensive). Results A diagnosis of AD was associated with higher odds of active smoking (OR 1.87, 95% confidence interval 1.32-2.63) and exposure to passive smoke (OR 1.18, 95% confidence interval 1.01-1.38), but not maternal smoking during pregnancy (OR 1.06, 95% confidence interval 0.80-1.40). The association between active smoking and AD remained significant in children and adults, all continents studied, and study sizes, but all were cross-sectional designs and had NOS score 6 or greater. Passive smoke was associated with AD in children and adults, cross-sectional studies, South/Central American and African studies, study size less than 5000, and NOS score less than 6. Limitations AD severity and distribution were not assessed. Conclusions Active and passive exposure to smoke are associated with increased AD prevalence.
KW - active smoking
KW - atopic dermatitis
KW - eczema
KW - meta-analysis
KW - passive smoking
KW - prenatal smoking
KW - prevalence
KW - systematic review
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U2 - 10.1016/j.jaad.2016.07.017
DO - 10.1016/j.jaad.2016.07.017
M3 - Article
C2 - 27542586
AN - SCOPUS:84995947891
SN - 0190-9622
VL - 75
SP - 1119-1125.e1
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 6
ER -