Association of atopic dermatitis with smoking: A systematic review and meta-analysis

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 - 2016/12/1

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 - Africa

KW - Age Factors

KW - Asia

KW - Central America

KW - Cross-Sectional Studies

KW - Dermatitis, Atopic

KW - Europe

KW - Female

KW - Humans

KW - North America

KW - Pregnancy

KW - Risk Factors

KW - Smoking

KW - South America

KW - Tobacco Smoke Pollution

KW - Journal Article

KW - Meta-Analysis

KW - Review

U2 - 10.1016/j.jaad.2016.07.017

DO - 10.1016/j.jaad.2016.07.017

M3 - Review

C2 - 27542586

SN - 0190-9622

VL - 75

SP - 1119-1125.e1

JO - American Academy of Dermatology. Journal

JF - American Academy of Dermatology. Journal

IS - 6

ER -