Atopic dermatitis and tobacco smoke exposure during childhood and adolescence.

Background: Tobacco smoke may affect atopic dermatitis (AD) because of its known effects on humoral and cellular immunity, but prior studies lack data on disease severity and biomarkers over time.
Objective: We investigated the association between passive and active tobacco smoke exposure (TSE) during childhood and adolescence and the activity and severity of AD.
Methods: A birth cohort of 10,521 individuals was followed through adolescence as part of the Avon Longitudinal Study of Parents and Children. We used mixed-effect models to determine the risk of AD (based on repeated assessments) with passive smoke exposure during childhood, active TSE during adolescence, and using a serum biomarker of tobacco exposure (cotinine) at 3 time points.
Results: After adjusting for confounding factors, there was no evidence of a relationship between passive TSE and concurrent AD activity in childhood (adjusted odds ratio, 0.95; 95% confidence interval, 0.83, 1.07) or of an increased risk between active smoking and AD activity in adolescence (adjusted odds ratio, 0.57; 95% confidence interval, 0.44, 0.75). Secondary analyses demonstrated no dose-response relationship and no increased severity of AD with passive or active TSE. Furthermore, we found no increased risk of AD with a cumulative measure of passive TSE across childhood (adjusted relative risk ratio, 0.98; 95% confidence interval, 0.96, 1.00).
Conclusion: Neither active nor passive TSE was associated with AD during childhood and adolescence.
Competing Interests: Funded by National Institutes of Health grants via Arthritis and Musculoskeletal and Skin Diseases Career Development Award K23AR073915 (to K.A.), National Center for Advancing Translational Sciences award UCSF-CTSI grant UL1 TR001872 (to C.E.M.), and UCSF-CTSI grant TL1TR001871 (to F.R.). Funding was also received from a Wellcome Trust Senior Research Fellowship in Clinical Science (award 205039/Z/16/Z to S.M.L.); and from the UCSF Summer Explore Fellowship (to N.A.A. and L.N.C.). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the report. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the funders. The UK Medical Research Council and Wellcome (grant 217065/Z/19/Z) and the University of Bristol provide core support for ALSPAC. This publication is the work of the authors and will serve as guarantors for its contents. A comprehensive list of grant funding is available on the ALSPAC website (www.bristol.ac.uk/alspac/external/documents/grant-acknowledgements.pdf). Disclosure of potential conflict of interest: K. Abuabara reports receipt of consulting fees from TARGET RWE and grants to her institution from Pfizer and Cosmetique International SNC. The rest of the authors declare that they have no relevant conflicts of interest.
(© 2024 The Authors.)