The impact of exposure to tobacco smoke and e‐cigarettes on asthma‐related outcomes: Systematic review informing the EAACI guidelines on environmental science for allergic diseases and asthma

Author:

Agache Ioana1ORCID,Ricci‐Cabello Ignacio2345,Canelo‐Aybar Carlos56,Annesi‐Maesano Isabella7ORCID,Cecchi Lorenzo8ORCID,Biagioni Benedetta9,Chung Kian Fan10ORCID,D'Amato Gennaro1112ORCID,Damialis Athanasios13ORCID,del Giacco Stefano14ORCID,De Las Vecillas Leticia15ORCID,Dominguez‐Ortega Javier15,Galán Carmen16ORCID,Gilles Stefanie17ORCID,Giovannini Mattia1819,Holgate Stephen20,Jeebhay Mohamed21ORCID,Nadeau Kari22ORCID,Papadopoulos Nikolaos2324ORCID,Quirce Santiago15,Sastre Joaquin25,Traidl‐Hoffmann Claudia172627ORCID,Walusiak‐Skorupa Jolanta28,Salazar Josefina5,Sousa‐Pinto Bernardo29,Colom Miquel25,Fiol‐deRoque Maria A.23530,Gorreto López Lucía531,Malih Narges235,Moro Laura5ORCID,Pardo Marina García532,Pazo Patricia García25,Campos Rocío Zamanillo235,Saletti‐Cuesta L.5,Akdis Mubeccel33ORCID,Alonso‐Coello Pablo456,Jutel Marek34ORCID,Akdis Cezmi A.33ORCID

Affiliation:

1. Faculty of Medicine Transylvania University Brasov Romania

2. Research Group in Primary Care and Promotion – Balearic Islands Community (GRAPP‐caIB) Health Research Institute of the Balearic Islands (IdISBa) Palma Spain

3. Primary Care Research Unit of Mallorca Balearic Islands Health Services Palma Spain

4. CIBER Biomedical Research Center in Epidemiology and Public Health (CIBERESP) Health Institute Carlos III (ISCIII) Madrid Spain

5. Iberoamerican Cochrane Centre Barcelona Spain

6. Institut de Recerca Sant Pau (IR SANT PAU) Barcelona Spain

7. Institute Desbrest of Epidemiology and Public Health, INSERM, University Hospital, University of Montpellier Montpellier France

8. SOSD Allergy and Clinical Immunology USL Toscana Centro Prato Italy

9. Allergy and Clinical Immunology Unit San Giovanni di Dio Hospital Florence Italy

10. Imperial College London UK

11. Respiratory Disease Department Hospital Cardarelli Naples Italy

12. Medical School of Respiratory Allergy University of Naples Federico II Naples Italy

13. Terrestrial Ecology and Climate Change, Department of Ecology, School of Biology, Faculty of Sciences Aristotle University of Thessaloniki Thessaloniki Greece

14. Department of Medical Sciences and Public Health University of Cagliari Monserrato Italy

15. Department of Allergy Hospital La Paz Institute for Health Research (IdiPAZ) Madrid Spain

16. Inter‐University Institute for Earth System Research (IISTA), International Campus of Excellence on Agrifood (ceiA3), University of Córdoba Córdoba Spain

17. Environmental Medicine, Faculty of Medicine University of Augsburg Augsburg Germany

18. Allergy Unit Meyer Children's Hospital IRCCS Florence Italy

19. Department of Health Sciences University of Florence Florence Italy

20. Faculty of Medicine University of Southampton Southampton UK

21. Occupational Medicine Division and Centre for Environmental & Occupational Health Research University of Cape Town Cape Town South Africa

22. John Rock Professor of Climate and Population Studies Chair, Department of Environmental Health, Interim Director, Center for Climate, Health, and the Global Environment, Harvard T.H. Chan School of Public Health Boston Massachusetts USA

23. Allergy and Clinical Immunology Unit, Second Pediatric Clinic National and Kapodistrian University of Athens Athens Greece

24. Division of Evolution and Genomic Sciences University of Manchester Manchester UK

25. Allergy Service, Fundación Jiménez Díaz Faculty of Medicine Universidad Autónoma de Madrid and CIBERES, Instituto Carlos III, Ministry of Science and Innovation Madrid Spain

26. Institute of Environmental Medicine, Helmholtz Munich – German Research Center for Environmental Health Augsburg Germany

27. Christine‐Kühne Center for Allergy Research and Education Davos Switzerland

28. Department of Occupational Diseases and Environmental Health Nofer Institute of Occupational Medicine Lodz Poland

29. MEDCIDS – Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine University of Porto Porto Portugal

30. Prevention and Health Promotion Research Network (redIAPP)/Network for Research on Chronicity, Primary Care, and Health Promotion (RICAPPS) Barcelona Spain

31. Gabinete técnico de atención primaria de Mallorca, Balearic Islands Health Services Palma Spain

32. Servicio de urgencias de atención primaria de Inca, Balearic Islands Health Services Palma Spain

33. Swiss Institute of Allergy and Asthma Research (SIAF), University Zurich Davos Switzerland

34. Department of Clinical Immunology Wrocław Medical University, ALL‐MED Medical Research Institute Wroclaw Poland

Abstract

AbstractTo inform the clinical practice guidelines' recommendations developed by the European Academy of Allergy and Clinical Immunology systematic reviews (SR) assessed using GRADE on the impact of environmental tobacco smoke (ETS) and active smoking on the risk of new‐onset asthma/recurrent wheezing (RW)/low lung function (LF), and on asthma‐related outcomes. Only longitudinal studies were included, almost all on combustion cigarettes, only one assessing e‐cigarettes and LF. According to the first SR (67 studies), prenatal ETS increases the risk of RW (moderate certainty evidence) and may increase the risk of new‐onset asthma and of low LF (low certainty evidence). Postnatal ETS increases the risk of new‐onset asthma and of RW (moderate certainty evidence) and may impact LF (low certainty evidence). Combined in utero and postnatal ETS may increase the risk of new‐onset asthma (low certainty evidence) and increases the risk of RW (moderate certainty evidence). According to the second SR (24 studies), ETS increases the risk of severe asthma exacerbations and impairs asthma control and LF (moderate certainty evidence). According to the third SR (25 studies), active smoking increases the risk of severe asthma exacerbations and of suboptimal asthma control (moderate certainty evidence) and may impact asthma‐related quality‐of‐life and LF (low certainty evidence).

Publisher

Wiley

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