Secondhand Tobacco Smoke Exposure and Chronic Rhinosinusitis: A Population-Based Case–Control Study

Abstract

Background Rhinosinusitis is a costly disease that adversely affects quality of life (QOL). It is known to be influenced by environmental factors, but few studies have evaluated the association between secondhand tobacco smoke (SHS) exposure and chronic rhinosinusitis (CRS). To address this evidence gap, we evaluated the association of SHS and CRS risk in a community-based case–control study of adult nonsmokers. Methods In Washington County, MD, 100 cases with a confirmed diagnosis of CRS and 100 controls matched for age, sex, and smoking status (former–never) were recruited and interviewed. A validated questionnaire was used to assess past and present SHS exposure as well as disease-specific QOL. Results Compared with those who reported no SHS exposure, current or childhood SHS exposure was associated with significantly increased risk of CRS (odds ratio, 2.33; 95% CI, 1.02, 5.34). CRS cases exposed to SHS (n = 39) had worse mean scores in nasal obstruction/blockage (3.1 versus 2.5; p = 0.02), nasal discharge (3.3 versus 2.7; p = 0.03), headaches (2.4 versus 1.5; p = 0.01), and cough (2.1 versus 1.5; p = 0.04) than cases without SHS exposure (n = 61). Cases exposed to SHS were also more likely to use nasal decongestants (53.9% versus 34.4%; p = 0.05). Conclusion Exposure to SHS during childhood and adulthood may be a risk factor for CRS. Furthermore, compared with unexposed CRS cases, SHS exposed cases reported worse nasal symptoms and used more nasal decongestants compared with unexposed cases, suggesting SHS exposure is related to exacerbation and more severe symptoms.