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. Author manuscript; available in PMC: 2020 Jun 10.
Published in final edited form as: Int Forum Allergy Rhinol. 2018 Feb;8(2):108–352. doi: 10.1002/alr.22073

TABLE VI.E.

Evidence for the effect of active and passive tobacco smoke exposure on the development of allergic rhinitis

Study Year LOE Study design Active vs passive
smoke exposure		 Study groups Clinical endpoint Conclusion
Saulyte et al.593 2014 2a SR of cohort, cross-sectional, and case-control studies Both

  1. Active smoking;

  2. Passive smoking;

  3. No active or passive smoking

 Diagnosis of AR No association between active smoking and maternal pre-natal passive smoking and AR. Significant association between all other passive smoking and AR.
Codispoti et al.599 2010 2b Prospective cohort study Passive

  1. Environmental tobacco smoke exposure;

  2. No exposure

 Diagnosis of AR by age 3 years Environmental tobacco exposure has no effect on the development of AR by age 3 years.
Keil et al.596 2009 2b Prospective cohort study Passive Maternal smoking vs no smoke exposure with:

  1. 2 Allergic parents;

  2. 1 Allergic parent;

  3. Non-allergic parents

 Diagnosis of AR over the first 10 years of life There was no association between maternal smoking and the development of AR regardless of the allergic status of the parents.
Bendtsen et al.598 2008 2b Prospective cohort study Active

  1. Current smoking;

  2. No current smoking

 Self-reported SAR or PAR Smoking more than 15 cigarettes/day was associated with a decreased risk of SAR.
Annesi-Maesano et al.600 1997 2b Prospective cohort study Active

  1. Lifetime nonsmokers;

  2. Ex-smokers(>1 month);

  3. Current smokers

 Chronic rhinitis, SAR, or perceived nasal hyperresponsiveness No association between smoking and seasonal AR. Significant association between chronic rhinitis and current smoking.
Wright et al.597 1994 2b Prospective cohort study Passive

  1. Maternal smoking;

  2. No smoking in the first year

 Physician diagnosed AR at age 6 years No significant association between maternal smoking and physician diagnosed AR.
Hur et al.594 2014 3a SR of predominantly case-control studies Passive

  1. Exposure to passive smoking;

  2. No exposure to passive smoking

 Diagnosis of AR Most studies did not show a relationship between passive smoke exposure and AR.

AR = allergic rhinitis; LOE = level of evidence; PAR = perennial allergic rhinitis; SAR = seasonal allergic rhinitis; SR = systematic review.