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Association of atopic dermatitis with smoking: A systematic review and meta-analysis.
J Am Acad Dermatol 2016; 75(6):1119-1125.e1JA

Abstract

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.

Authors+Show Affiliations

Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.Department of Dermatology, and Allergology, Herlev-Gentofte University Hospital, Hellerup, Denmark.Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Northwestern Medicine Multidisciplinary Eczema Center, Chicago, Illinois. Electronic address: JonathanISilverberg@gmail.com.

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

27542586

Citation

Kantor, Robert, et al. "Association of Atopic Dermatitis With Smoking: a Systematic Review and Meta-analysis." Journal of the American Academy of Dermatology, vol. 75, no. 6, 2016, pp. 1119-1125.e1.
Kantor R, Kim A, Thyssen JP, et al. Association of atopic dermatitis with smoking: A systematic review and meta-analysis. J Am Acad Dermatol. 2016;75(6):1119-1125.e1.
Kantor, R., Kim, A., Thyssen, J. P., & Silverberg, J. I. (2016). Association of atopic dermatitis with smoking: A systematic review and meta-analysis. Journal of the American Academy of Dermatology, 75(6), pp. 1119-1125.e1. doi:10.1016/j.jaad.2016.07.017.
Kantor R, et al. Association of Atopic Dermatitis With Smoking: a Systematic Review and Meta-analysis. J Am Acad Dermatol. 2016;75(6):1119-1125.e1. PubMed PMID: 27542586.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Association of atopic dermatitis with smoking: A systematic review and meta-analysis. AU - Kantor,Robert, AU - Kim,Ashley, AU - Thyssen,Jacob P, AU - Silverberg,Jonathan I, Y1 - 2016/08/16/ PY - 2016/04/20/received PY - 2016/07/05/revised PY - 2016/07/09/accepted PY - 2016/8/21/pubmed PY - 2017/4/20/medline PY - 2016/8/21/entrez KW - active smoking KW - atopic dermatitis KW - eczema KW - meta-analysis KW - passive smoking KW - prenatal smoking KW - prevalence KW - systematic review SP - 1119 EP - 1125.e1 JF - Journal of the American Academy of Dermatology JO - J. Am. Acad. Dermatol. VL - 75 IS - 6 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. SN - 1097-6787 UR - https://www.unboundmedicine.com/medline/citation/27542586/Association_of_atopic_dermatitis_with_smoking:_A_systematic_review_and_meta_analysis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0190-9622(16)30495-9 DB - PRIME DP - Unbound Medicine ER -