The dose-response relationship between tobacco smoking and hidradenitis suppurativa: results from an observational study of 1689 patients.

Abstract

Introduction: Available studies show conflicting results on the relationship between smoking characteristics (age at beginning, importance of consumption) and disease characteristics (disease onset, phenotype and severity).The objective of the study was to better understand the influence of smoking on HS characteristics.

Methods: The clinical characteristics and smoking habits of 1689 HS patients were assessed and compared between never-, past-, and active-smokers using Student's t, Fischer's exact, and χ² tests. Association analyses were done using Spearman's method and logistic regressions.

Results: There was a positive association between the mean age at smoking onset and the mean age at HS onset (ρ=0.4; p<0.001). Smokers were associated with a more severe disease: the number of affected sites was positively associated with the number of pack-years (ρ=0.126, p=0.0002). There was also a significant association between active-smoking and a poorer quality of life (p<0.001), as well as increased pain during HS flares (p<0.003).

Conclusion: Smoking early is associated to earlier onset of HS and heavy HS smokers develop a more severe disease in a dose-response manner. These results may support evidence-based counselling efforts for smoking cessation in HS patients and patients at risk of HS.