Assessing the Complex Impact of Smoking Habits on Allergic Rhinitis: A National Cross-Sectional Study.

Abstract

Objectives: Allergic rhinitis (AR) significantly affects quality of life and generates socioeconomic costs. The impact of smoking habits, including the use of conventional cigarettes (CC) and electronic cigarettes (EC), on AR prevalence and management remains controversial. To investigate the association between smoking status (CC and EC use) and AR prevalence and management among Koreans, data from the Korea National Health and Nutrition Examination Survey (KNHANES) VII (2018) and VIII (2019-2021) were analyzed.

Methods: This cross-sectional study included 22,290 participants aged ≥19 years from the KNHANES. Smoking status was self-reported, and urinary cotinine levels were measured to assess nicotine exposure. Statistical analyses, including logistic regression, were employed to examine the relationships between smoking status, cotinine levels, and AR prevalence and management.

Results: In univariable logistic regression analysis, compared to non-smokers, electronic cigarette (EC) users showed a 35.8% increased risk of allergic rhinitis (AR), while conventional cigarette (CC) users had a 27.7% lower risk. In multivariable logistic regression analysis, CC users demonstrated a 20.3% lower risk, but no significant association was found among EC users. High cotinine levels (>500 ng/ml) were inversely related to AR prevalence. Among heavy CC users with high cotinine levels, a 35% reduced risk of AR was observed, but after adjusting for confounders, the association was no longer significant, suggesting that other variables may mediate this relationship.

Conclusion: Smoking status is associated with the prevalence of allergic rhinitis (AR) in Koreans, and heavy use of conventional cigarettes (CC) shows a negative correlation with AR prevalence.