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 - Copyright © 2016 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.
PY - 2016/12
Y1 - 2016/12
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.
U2 - 10.1016/j.jaad.2016.07.017
DO - 10.1016/j.jaad.2016.07.017
M3 - Journal article
C2 - 27542586
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 -