Abstract
Smoking has been identified as a risk factor for atopic dermatitis and hand eczema, but less is known about the association of exposure to second-hand smoke (SHS) with hand eczema. The study aimed to investigate the association of SHS exposure with hand eczema and atopic dermatitis in a group of adolescents. We conducted a cross-sectional study among first-year college students. SHS exposure was measured by a self-administered questionnaire. Skin diseases were diagnosed by dermatologists in the field survey. Mixed models were used to estimate the associations. A total of 20,129 participants that underwent skin examination and a questionnaire survey were included in the analyses. The prevalence rates of atopic dermatitis and hand eczema were 3.86% and 3.35%, respectively. Crude and adjusted estimates consistently showed that exposure to SHS was significantly associated with atopic dermatitis and hand eczema in a dose–response manner. Attention deficit/hyperactivity disorder mediated minimal or no effect of SHS on hand eczema and atopic dermatitis. Subgroup analysis by type of hand eczema, and sensitivity analysis by excluding data with center effect showed consistent results. Exposure to SHS is an independent but modifiable risk factor for hand eczema and atopic dermatitis in adolescents.
Highlights
Tobacco smoking has been the major cause of preventable morbidity and mortality in the world
We investigated the associations of second-hand smoke (SHS) exposure with diagnosed atopic dermatitis and hand eczema in a group of homogeneous adolescents who have experienced comparable social and environmental transitions China
SHS exposure showed a positive association with family income, attention deficit/hyperactivity disorder (ADHD), asthma, and allergic rhinitis
Summary
Tobacco smoking has been the major cause of preventable morbidity and mortality in the world. According to the World Health Organization’s recent report on global tobacco use, the Western Pacific Region, including China, is projected to overtake South East Asia as the region with the highest rate of smoking among m en[1]. Previous studies demonstrated that US and Danish adults with atopic dermatitis had higher risk for cardiovascular disease, and the association might be attributable to or mediated by poor health behaviors including s moking[6,7,8].
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