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Cigarette smoking and allergic sensitization: A 32-year population-based cohort study

https://doi.org/10.1016/j.jaci.2007.09.052Get rights and content

Background

Cigarette smoke has immunosuppressant effects, but its effect on allergic sensitization is unclear.

Objective

To investigate associations between parental and personal smoking and skin prick tests (SPTs) for atopy in a population-based birth cohort of 1037 participants followed to adulthood.

Methods

Parental history of atopic disease, parental smoking, and personal smoking were obtained at multiple assessments between birth and age 32 years. Atopy was assessed by SPTs for 11 common inhaled allergens at ages 13 and 32 years.

Results

Children of atopic parents were less likely to have positive SPTs at age 13 years if either parent smoked (odds ratio, 0.55; P = .009). This association was not significant after adjusting for breast-feeding history, number of siblings, and childhood socioeconomic status. Subjects with atopic parents were also less likely to develop positive results to SPTs between ages 13 and 32 years if they smoked themselves (odds ratio, 0.18; P < .001). This reduction in risk remained significant after adjusting for multiple potential confounding factors. Neither parental nor personal smoking was significantly associated with allergic sensitization among subjects whose parents did not have a history of atopic disease. Few of those with positive SPT results at age 13 years had negative tests at age 32 years, and there was no evidence that this was influenced by smoking.

Conclusion

Personal and parental smoking is associated with a reduced risk of allergic sensitization in people with a family history of atopy.

Section snippets

Methods

The Dunedin Multidisciplinary Health and Development Study is described in detail elsewhere.27 Briefly, this is a longitudinal study of an unselected birth cohort of 1037 individuals (52% male) born in Dunedin in 1972 or 1973. The cohort represents the full range of socioeconomic status in New Zealand's South Island, and study members are mostly of New Zealand/European ethnicity. A broad range of health, behavioral, and developmental assessments has been conducted at birth and ages 3, 5, 7, 9,

Results

At age 13 years, 196 of 375 (52%) male study members and 132 of 349 (38%) female study members were atopic on SPTs (P < .001). At age 32 years, there was no sex difference in prevalence when 292 of 479 (61%) men and 268 of 467 (57%) women were atopic (P = .26).

Only 7 study members (1%) were daily smokers at age 13 years, whereas 32 (4%) smoked at least weekly. Those who were atopic at age 13 years were more likely to smoke at least weekly (5.8%) compared with those who were not atopic (3.3%),

Discussion

In this general population sample followed from birth to 32 years, we found that children who were exposed to parental smoking and those who took up cigarette smoking themselves had a lower incidence of atopy to a range of common inhaled allergens. These associations were found only in those with a parental history of asthma or hay fever. The findings support the hypothesis that the immune-suppressant effects of cigarette smoke may reduce the risk of allergic sensitization. By contrast, there

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    • Cited by (0)

    The Dunedin Multidisciplinary Health and Development Research Unit is supported by the Health Research Council of New Zealand. M.R.S. holds the AstraZeneca Chair in Respiratory Epidemiology at McMaster University.

    Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.

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    Copyright © 2008 American Academy of Allergy, Asthma & Immunology. Published by Mosby, Inc. All rights reserved.