Position Statement on the Effects of Cigarette Smoke on Allergic Diseases

Arlene Grace Sandejas; Maria Rowena Valerio; Jacqueline Rodolfo; Gina Marie Ponio-Baloyo

doi:10.70552/pjaai.23.1.9859

Authors

Arlene Grace S. Sandejas, MD
Maria Rowena B. Valerio, MD
Jacqueline R. Rodolfo, MD https://orcid.org/0009-0007-7049-1836
Gina Marie E. Ponio-Baloyo, MD

DOI:

https://doi.org/10.70552/pjaai.23.1.9859

Keywords:

allergic diseases, tobacco, allergic rhinitis, smoking

Abstract

Environmental tobacco smoke exposure is one of the major causes of air pollution that has been suspected to play a role in the rise of allergic diseases worldwide. Studies have shown that exposure to environmental tobacco smoke during pregnancy and during childhood increases the risk of developing not only allergic airway diseases but also allergic skin diseases. Smokefree legislation has been shown to help in decreasing the burden of allergic diseases in the country. Thus, we fully support the implementation of smokefree legislation in the hope that it will continue to decrease the number of smokers in the country. We strive to educate our patients against the ill effects of environmental tobacco smoke and continue to urge current smokers to quit smoking, not only for themselves but for their entire family.

Author Biographies

Arlene Grace S. Sandejas, MD

Department of Pediatrics, Manila Doctors Hospital, Philippines

Correspondence to:
Arlene Grace S. Sandejas, MD
Philippine Society of Allergy, Asthma and Immunology, Inc.
Unit 2504 Medical Plaza Ortigas Condominium, 25 San Miguel Avenue, Ortigas Center, Pasig City
Tel.: +63 9175396426
E-mail: arlene.sandejas@gmail.com

Maria Rowena B. Valerio, MD

Department of Pediatrics, Sacred Heart Medical Center, Angeles City, Pampanga, Philippines

Jacqueline R. Rodolfo, MD

Department of Pediatrics, Medical Center Manila, Philippines

Gina Marie E. Ponio-Baloyo, MD

Department of Pediatrics, Green City Medical Center, San Fernando, Pampanga, Philippines

References

Yang HJ. Impact of perinatal environmental tobacco smoke on the development of childhood allergic diseases. Korean J Pediatric.

;59(8):19-27. https://pubmed.ncbi.nlm.nih.gov/27610180 https://www.ncbi.nlm.nih.gov/pmc/articles/ PMC5014911 https://doi.org/10.3345/kjp.2016.59.8.319 DOI: https://doi.org/10.3345/kjp.2016.59.8.319

Saulyte J, Regueira C, Montes-Martínez A, Khudyakov P, Takkouche B. Active or passive exposure to tobacco smoking and allergic rhinitis, allergic dermatitis, and food allergy in adults and children: a systematic review and meta-analysis. PLoS Medicine. 2014;11(3):e1001611. https://pubmed.ncbi.nlm.nih.gov/24618794 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3949681 https://doi.org/10.1371/journal.pmed.1001611 DOI: https://doi.org/10.1371/journal.pmed.1001611

World Health Organization. 2021 GATS Fact Sheet Philippines. 2021 GATS Fact Sheet Philippines. https://www.who.int/publications/m/

item/2021-gats-fact-sheet-philippines

World Health Organization. 2019 GYTS Fact Sheet Philippines. 2019 GYTS Fact Sheet Philippines. https://www.who.int/publications/m/

item/2019-gyts-fact-sheet-philippines

Repace J. Exposure to secondhand smoke. In: Ott WR, Steinemann AC, Wallace LA (eds). Exposure analysis, 1st ed, ch. 9. USA: CRC

Press, Taylor & Francis Group; 2009. http://www.repace.com/pdf/EXPOSURE_TO_SECONDHAND_SMOKE.pdf

US Department of Health and Human Services. Let’s make the next generation tobacco-free: your guide to the 50th anniversary Surgeon general’s report on smoking and health; 2014. https://www.hhs.gov/sites/default/files/consequences-smoking-consumer-guide.pdf

Mahabee-Gittens EM, Merianos AL, Matt G. Preliminary evidence that high levels of nicotine on children's hands may contribute to overall tobacco smoke exposure. Tob Control. 2018;27(2)217-9. https://pubmed.ncbi.nlm.nih.gov/28360145 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5623162 https://doi.org/10.1136/tobaccocontrol-2016-053602 DOI: https://doi.org/10.1136/tobaccocontrol-2016-053602

Liu AH, Babineau DC, Krouse RZ, et al. Pathways through which asthma risk factors contribute to asthma severity in inner – city children. J Allergy Clin Immunol. 2016;138(4):1042-50. https://pubmed.ncbi.nlm.nih.gov/27720018 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5381517 https://doi.org/10.1016/j.jaci.2016.06.060 DOI: https://doi.org/10.1016/j.jaci.2016.06.060

Kresk N, Ankrum A, Cerdá M, Chen Q, Hasin D, Martins S, Olfson M, Keyes K, Nicotine Vaping and Co-occurring substance use among

adolescents in the United States from 2017-2019, Substance use and misuse, 2023:58(9), 1075-79. https://doi.org/10.1080/10826084.2023.2188462 DOI: https://doi.org/10.1080/10826084.2023.2188462

Ahn K. The role of air pollutants in atopic dermatitis. J Allergy Clin Immunol. 2014;134(5):993-9. https://pubmed.ncbi.nlm.nih.gov/25439225 https://doi.org/10.1016/j.jaci.2014.09.023 DOI: https://doi.org/10.1016/j.jaci.2014.09.023

Kantor R, Silverberg JI. Environmental risk factors and their role in the management of atopic dermatitis. Expert Rev Clin Immunol. 2017;13(1):15-26. https://pubmed.ncbi.nlm.nih.gov/27417220 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5216178 https://doi.org/10.1080/1744666X.2016.1212660 DOI: https://doi.org/10.1080/1744666X.2016.1212660

Wang IJ, Chen SL, Lu TP, Chuang EY, Chen PC. Prenatal smoke exposure, DNA methylation, and childhood atopic dermatitis. Clin

Exp Allergy. 2013;43(5):535-43. https://pubmed.ncbi.nlm.nih.gov/23600544 https://doi.org/10.1111/cea.1210813.

Winter M, Thürmann L, Gu Z, et al. The benzene metabolite 1, 4-benzoquinone reduces regulatory T-cell function: a potential mechanism for tobacco smoke–associated atopic dermatitis. J Allergy Clin Immunol. 2017;140(2):603-5. https://pubmed.ncbi.nlm.nih.gov/28274748 https://doi.org/10.1016/j.jaci.2017.01.034 DOI: https://doi.org/10.1016/j.jaci.2017.01.034

Adkinson NF, Bochner BS, Burks AW, et al. Middleton’s Allergy: Principles and Practice, 8th ed. Elsevier Inc; 2013.

Graif Y, German L, Ifrah A, Liyne I, Shohat T. Dose-response association between smoking and atopic eczema: results from a

large cross-sectional study in adolescents. Dermatology, 2013;226(3):195-9. https://pubmed.ncbi.nlm.nih.gov/23711459 https://doi.org/10.1159/000348333 DOI: https://doi.org/10.1159/000348333

Shirinde J, Wichmann J, Voyi K. Environmental tobacco smoke and the risk of eczema symptoms among school children in South Africa: a cross sectional study. BMJ Open. 2015; 5(8) e008234. https://pubmed.ncbi.nlm.nih.gov/26310401 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4554914 https://doi.org/10.1136/bmjopen-2015-008234 DOI: https://doi.org/10.1136/bmjopen-2015-008234

Waked M, Salameh P. Maternal water pipe smoke exposure and the risk of asthma and allergic diseases in childhood: a post hoc

analysis. Int J Occup Med Environ Health. 2015:28(1):147-56. https://pubmed.ncbi.nlm.nih.gov/26159955 https://doi.org/10.13075/ijomeh.1896.00316 DOI: https://doi.org/10.13075/ijomeh.1896.00316

Lee CH, Chuang HY, Hong CH et al. Lifetime exposure to cigarette smoking and the development of adult-onset atopic dermatitis. Br

J Dermatol. 2011;164(3):483-9. https://pubmed.ncbi.nlm.nih.gov/:21054333 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3062947 https://doi.org/10.1111/j.1365-2133.2010.10116.x DOI: https://doi.org/10.1111/j.1365-2133.2010.10116.x

Jayes L, Haslam PLG, Powell P, et al. SmokeHaz: systematic reviews and meta-analyses of the effects of smoking on respiratory health. Chest 2016; 50 (1): 164 – 79. https://pubmed.ncbi.nlm.nih.gov/27102185 https://doi.org/10.1016/j.chest.2016.03.060 DOI: https://doi.org/10.1016/j.chest.2016.03.060

Genuneit J, Seibold A, Apfelbacher C, et al. The state of asthma epidemiology: an overview of systematic reviews and their quality.

Clin Transl Allergy. 2017; 7:12. https://pubmed.ncbi.nlm.nih.gov/284000946 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5387188 https://doi.org/10.1186/s13601-017-0146-y DOI: https://doi.org/10.1186/s13601-017-0146-y

Zhang L, He L, Gong J et al. Risk factors associated with irreversible airway obstruction in asthma: a systematic review and meta-analysis. Biomed Res Int. 2016;9868704. MID:27119087 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828538 https://doi.org/10.1155/2016/9868704 DOI: https://doi.org/10.1155/2016/9868704

Rusznac C, Mills PR, Devalia JL, Sapsford RF, Davies RJ, Lozewicz S. Effect of cigarette smoke on the permeability and IL – 1 beta and

sICAM – 1 release from cultured human bronchial cells of neversmokers, smokers and patients with chronic obstructive pulmonary

disease. Am J Respir Cell Mol Biol 2000;23(4):530-6. https://pubmed.ncbi.nlm.nih.gov/11017919 https://doi.org/10.1165/ajrcmb.23.4.3959 DOI: https://doi.org/10.1165/ajrcmb.23.4.3959

Rusznack C, Sapsford RJ, Devalia JL, et al. Cigarette smoke potentiates house dust mite allergen – induced increased in the permeablity of human bronchial epithelial cells in vitro. Am J Respir Cell Mol Biol 1999;20(6):1238-50. https://pubmed.ncbi.nlm.nih.gov/10340943 https://doi.org/10.1165/arjcmb.20.6.3226 DOI: https://doi.org/10.1165/ajrcmb.20.6.3226

Lanchacker EA, Tournoy KG, Hammad et al. Short cigarette smoke exposures facilitates sensitization and asthma development in

mice. Eur Respir J 2013;41(5):1189-99. https://pubmed.ncbi.nlm.nih.gov/22903968 https://doi.org/10.1183/09031936.00096612 DOI: https://doi.org/10.1183/09031936.00096612

Trimble NJ, Botelho FM, Bauer Cm, Fattouh R, Stampfli MR. Adjuvant and anti-inflammatory properties of cigarette smoke in murine

allergic airway inflammation. Am J Respir Cell Mol Bio.I 2009;40(1): 38-46. https://pubmed.ncbi.nlm.nih.gov/18635815 https://doi.org/10.1165/rcmb.2008.0107OC DOI: https://doi.org/10.1165/rcmb.2008-0107OC

Stapleton M, Howard – Thompson A, George C, Hoover RM, Self TH. Smoking and asthma. Am Board Fam Med, 2011; 24(3):313-22. https://pubmed.ncbi.nlm.nih.gov/2155404 https://doi.org/10.3122/jabfm.2011.03.100180 DOI: https://doi.org/10.3122/jabfm.2011.03.100180

Esteban-Gorgojo I, Antolin-Amergio D, Dominguez-Ortega J, Quirce S. Non- eosinophilic asthma: current perspectives. J Asthma Allergy. 2018;11:267-81. https://pubmed.ncbi.nlm.nih.gov/30464537 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6211679 https://doi.org/10.2147/JAA.S153097 DOI: https://doi.org/10.2147/JAA.S153097

Diaz-Sanchez D, Rumold R, Gong H Jr. Challenge with environmental tobacco smoke exacerbates allergic airway disease in human

beings. J Allergy Clin Immunol 2006; 118(2):441-6. https://pubmed.ncbi.nlm.nih.gov/16890770 https://doi.org/10.1016/j.jaci.2006.04.047 DOI: https://doi.org/10.1016/j.jaci.2006.04.047

Schembri F, Sridhar S, Perdomo C, et al. MicroRNAs as modulators of smoking-induced gene expression changes in human airway

epithelium. Proc Natl Acad Sci USA. 2009;106(7):2319-24. https://pubmed.ncbi.nlm.nih.gov/19168627 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2650144 https://doi.org/10.1073/pnas.0806383106 DOI: https://doi.org/10.1073/pnas.0806383106

Spira A, Bane J, Shah V, et al. Effects of cigarette smoke on human airway epithelial cell transcriptome. Proc Natl Acad Sci USA 2004;101: 10143-8. https://pubmed.ncbi.nlm.nih.gov/15210990 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC454179 https://doi.org/10.1073/pnas.0401422101 DOI: https://doi.org/10.1073/pnas.0401422101

Joubert BR, Felix JF, Yousefi P, et al. DNA methylation in newborns and maternal smoking in pregnancy: genome-wide consortium

meta-analysis. Am J Hum Genet. 2016;98(4):680-96. https://pubmed.ncbi.nlm.nih.gov/27040690 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4833289 https://doi.org/10.1016/j.ajhg.2016.02.019 DOI: https://doi.org/10.1016/j.ajhg.2016.02.019

Vonk JM, Scholtens S, Postman DS, et al. Adult onset asthma and interaction between genes and active tobacco smoking: the Gabriel

consortium: Plos One. 2017; 12(3):eo0172716. https://pubmed.ncbi.nlm.nih.gov/28253294 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5333809 https://doi.org/10.1371/journal.pone.0172716 DOI: https://doi.org/10.1371/journal.pone.0172716

Hallstrand TS, Hackett TL, Altemeier WA, Matute-Bello G, Hansbro PM, Knight DA. Airway epithelial regulation of pulmonary immune homeostasis and inflammation. Clin Immunol. 2014;151(1): 1-15. https://pubmed.ncbi.nlm.nih.gov/24503171 https://doi.org/10.1016/j.clim.2013.12.003 DOI: https://doi.org/10.1016/j.clim.2013.12.003

Coogan PF, Castro-Webb N, Yu J, O’Connor G, Palmer J, Rosenberg L. Active and passive smoking and the incidence of asthma in the black women’s health study. Am J Respir Crit Care Med. 2015;191(2):168-76. https://pubmed.ncbi.nlm.nih.gov/25387276 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4347433 https://doi.org/10.1164/rccm.201406-1108OC DOI: https://doi.org/10.1164/rccm.201406-1108OC

Hernandez ML, Burbank AJ, Alexis NE, et al. Electronic Cigarettes and Their Impact on Allergic Respiratory Diseases: a Work Group

Report of the AAAAI Environmental Exposures and Respiratory Health Committee J Allergy and Clinical Immunology Pract. 2021;9(3):

-51. https://pubmed.ncbi.nlm.nih.gov/33547027 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8232370 https://doi.org/10.1016/j.jaip.2020.12.065 DOI: https://doi.org/10.1016/j.jaip.2020.12.065

Shargorodsky J, Garcia-Esquinas E, Galán I, Navas-Acien A, Lin SY. Allergic sensitization, rhinitis and tobacco smoke exposure in US adults. PLoS One. 2015:10(7):eo0131957. https://pubmed.ncbi.nlm.nih.gov/26172447 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4501790 https://doi.org/10.1371/journal.pone.0131957 DOI: https://doi.org/10.1371/journal.pone.0131957

Zhou H, Wang X, Brighton L, Hazucha M, Jaspers I, Carson JL. Increased nasal epithelial ciliary beat frequency associated with lifestyle tobacco smoke exposure. Inhal Toxico. 2009;21(10):875-81. https://pubmed.ncbi.nlm.nih.gov/19555226 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2721908 https://doi.org/10.1080/08958370802555898 DOI: https://doi.org/10.1080/08958370802555898

Vandermeer J, Sha Q, Lane AP, Schleimer RP. Innate Immunity of sinonasal cavity: expression of messenger RNA for complement

cascade components and toll like receptor. Arch Otolaryngolo Head and Neck Surg. 2004;130(12):1374-80. https://pubmed.ncbi.nlm.nih.gov/15611395 https://doi.org/10.1001/archotol.130.12.1374 DOI: https://doi.org/10.1001/archotol.130.12.1374

Lee WK, Ramanathan Jr M, Spannhake EW, Lane AP. The cigarette smoke component acrolein inhibits expression of the innate immune components IL8 and human beta-defensin 2 by sinonasal epithelial cells. Am J Rhino. 2007;21(6):658-63. https://pubmed.ncbi.nlm.nih.gov/18201443 https://doi.org/10.2500/ajr.2007.21.3094 DOI: https://doi.org/10.2500/ajr.2007.21.3094

Yamin M, Holbrook EH, Gray ST, et al. Cigarette smoke combined with Toll like receptor 3 signaling triggers exaggerated epithelial

regulated upon activation, normal T cell expressed and secreted / CCL5 expression in chronic rhinosinusitis. J Allergy Clin Immunol.

;122(6):1145-53.e3. https://pubmed.ncbi.nlm.nih.gov/18986692 https://doi.org/10.1016/j.jaci.2008.09.033 DOI: https://doi.org/10.1016/j.jaci.2008.09.033

Beck LA, Stellato C, Beall LD, et al. Detection of chemokine RANTES and endothelial adhesion molecules in nasal polyps. J Allergy Clin

Immunol. 1996;98(4):766-80. https://pubmed.ncbi.nlm.nih.gov/8876553 https://doi.org/10.1016/s0091-6749(96)70126-4 DOI: https://doi.org/10.1016/S0091-6749(96)70126-4

Chung, SJ, Kim BK, Oh JH, et al. Novel tobacco products including electronic cigarette and heated tobacco products increase

risk of allergic rhinitis and asthma in adolescents: analysis of Korean youth survey. Allergy. 2020;75(7):1640-8. https://pubmed.ncbi.nlm.nih.gov/32003899 https://doi.org/0.1111/all.14212 DOI: https://doi.org/10.1111/all.14212

Rha, MS, Cho HJ, Yoon JY, Kim CH. Association between the use of electronic cigarettes and the prevalence of chronic rhinosinusitis

and allergic rhinitis: a nationwide cross-sectional study. Rhinology 2022;60(1):20-8. https://pubmed.ncbi.nlm.nih.gov/34941973 https://doi.org/10.4193/Rhin21.287 DOI: https://doi.org/10.4193/Rhin21.287

Koop CE. The health consequences of involuntary smoking: a report of the surgeon general. DHHS publication. no. (CDC) 87-8398. 1986. https://stacks.cdc.gov/view/cdc/20799/cdc_20799_DSI.pdf

American College of Allergy, Asthma and Immunology. Tobacco smoke has harmful impact on asthma, rhinitis and immunity. News Wise. October 29, 2009. https://www.newswise.com/articles/tobaccosmoke-has-harmful-impact-on-asthma-rhinitis-and-immunity

Republic Act 9211. June 23, 2003. http://www.officialgazette.gov.ph/2003/06/23/republic-act-n0-9211

Republic Act No. 10351. Implementing Guidelines: Revenue Regulation No. 17-2012. December 19, 2012. http://www.officialgazette.gov.ph/2012/12/19/republic-act-no-10351/. http://www.officialgazette.gov.ph/downloads/2012/12dec/20121219-RA-10351-BSA.pdf

Rodrigo P. 10 years since the signing of the sin tax law. Business World Online. January 15, 2023. https://www.bworldonline.com/opinion/2023/01/15/498372/10-years-since-the-signing-of-the-sin-tax-law/

Talavera, C. DTI urges e-commerce platform to follow vape law. Philstar.com. March 7, 2023. https://www.philstar.com/business/2023/03/07/2249751/dti-urges-e-commerce-platformfollow-vape-law

World Health Organization. 2021 GATS Comparison Fact Sheet Philippines (2021, 2015, 2009). 2021. https://www.who.int/publications/m/item/2021-gats-comparison-fact-sheetphilippines-(2021-2015-2009)

Faber T, Been JV, Reiss IK, Mackenbacj JP, Sheikh A. Smoke-free legislation and child health. NPJ Prim Care Respir Med. 2016;26:16067. https://pubmed.ncbi.nlm.nih.gov/27853176 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5113157 https://doi.org/10.1038/npjpcrm.2016.67 DOI: https://doi.org/10.1038/npjpcrm.2016.67