Tobacco Smoking and Hand Eczema: A Population-Based Study
Tobacco Smoking and Hand Eczema: A Population-Based Study
Background Tobacco smoking has been proposed to promote hand eczema.
Objectives To examine the association between tobacco smoking and hand eczema and to investigate a possible dose-response relation.
Methods A national environmental health survey was performed in 2007. A questionnaire was mailed to 43 905 individuals and responses were obtained from 25 851 (59%). Questions on 1-year prevalence of hand eczema and on previous and current smoking were included. Respondents were asked to report number of cigarettes per day and to provide information on history of atopy and frequency of hand exposure to water.
Results In total, answers regarding smoking and hand eczema were obtained from 25 428 individuals. Of regular daily smokers, 10·0% reported hand eczema vs. 9·1% of nonsmokers (P = 0·0951). A history of atopy showed the strongest influence on the occurrence of hand eczema: prevalence proportion ratio (PPR) 3·46. The PPR for hand eczema among individuals smoking > 15 cigarettes per day was 1·25 and 1·40 in uni- and multivariate analysis, respectively. Age, history of atopy, sex and water exposure were found to be confounders but not effect modifiers. A dose-response relation between level of smoking and 1-year prevalence of hand eczema was revealed with a PPR of 1·05 (P < 0·001) for the continuous variable of smoking habits, indicating a significantly increased prevalence of hand eczema among individuals with higher consumption of tobacco.
Conclusions An association between heavy smoking and hand eczema was confirmed. It is important to consider the level of exposure, as a dose-response relation was revealed, and to be aware of confounding factors.
Tobacco smoking has been discussed in several studies as a possible factor promoting hand eczema, but the findings have not been consistent. In a previous study we found that heavy smoking gave a slightly increased 1-year prevalence of hand eczema. Individual smoking habits may correlate with sex, age, history of atopy and various lifestyle factors. These factors are also of importance for the development and course of hand eczema.
Questionnaire-based public health surveys are performed regularly in Sweden. This paper is based on a national environmental health survey performed in 2007. About 44 000 individuals were sent a questionnaire including detailed questions on health and environmental exposures. Questions on tobacco smoking and hand eczema were included. The aims of the present study were to examine the association between self-reported tobacco smoking and the occurrence of hand eczema and to investigate a possible dose-response relation.
Abstract and Introduction
Abstract
Background Tobacco smoking has been proposed to promote hand eczema.
Objectives To examine the association between tobacco smoking and hand eczema and to investigate a possible dose-response relation.
Methods A national environmental health survey was performed in 2007. A questionnaire was mailed to 43 905 individuals and responses were obtained from 25 851 (59%). Questions on 1-year prevalence of hand eczema and on previous and current smoking were included. Respondents were asked to report number of cigarettes per day and to provide information on history of atopy and frequency of hand exposure to water.
Results In total, answers regarding smoking and hand eczema were obtained from 25 428 individuals. Of regular daily smokers, 10·0% reported hand eczema vs. 9·1% of nonsmokers (P = 0·0951). A history of atopy showed the strongest influence on the occurrence of hand eczema: prevalence proportion ratio (PPR) 3·46. The PPR for hand eczema among individuals smoking > 15 cigarettes per day was 1·25 and 1·40 in uni- and multivariate analysis, respectively. Age, history of atopy, sex and water exposure were found to be confounders but not effect modifiers. A dose-response relation between level of smoking and 1-year prevalence of hand eczema was revealed with a PPR of 1·05 (P < 0·001) for the continuous variable of smoking habits, indicating a significantly increased prevalence of hand eczema among individuals with higher consumption of tobacco.
Conclusions An association between heavy smoking and hand eczema was confirmed. It is important to consider the level of exposure, as a dose-response relation was revealed, and to be aware of confounding factors.
Introduction
Tobacco smoking has been discussed in several studies as a possible factor promoting hand eczema, but the findings have not been consistent. In a previous study we found that heavy smoking gave a slightly increased 1-year prevalence of hand eczema. Individual smoking habits may correlate with sex, age, history of atopy and various lifestyle factors. These factors are also of importance for the development and course of hand eczema.
Questionnaire-based public health surveys are performed regularly in Sweden. This paper is based on a national environmental health survey performed in 2007. About 44 000 individuals were sent a questionnaire including detailed questions on health and environmental exposures. Questions on tobacco smoking and hand eczema were included. The aims of the present study were to examine the association between self-reported tobacco smoking and the occurrence of hand eczema and to investigate a possible dose-response relation.
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