Does second hand smoke cause rhinosinusitis?

January 01, 0001

Does second hand smoke cause rhinosinusitis?

These Canadian and US investigators conduced a matched case- control study to establish associations between second hand smoke (SHS) and chronic rhinosinusitis (CRS). They included a total of 306 nonsmoking patients diagnosed as having an incident case of CRS and 306 age-matched, sex-matched, and race/ethnicity-matched nonsmoking control patients. They considered exposure to SHS for the 5 years before diagnosis of CRS (case patients) and before study entry (controls) for 4 primary sources: home, work, public places, and private social functions outside the home, such as parties, dinners, and weddings.

They found: "Of controls and case patients, respectively, 28 (9.1%) and 41 (13.4%) had SHS exposure at home, 21 (6.9%) and 57 (18.6%) at work, 258 (84.3%) and 276 (90.2%) in public places, and 85 (27.8%) and 157 (51.3%) at private social functions. Adjusted for potential confounders (socioeconomic status and exposures to air pollution and chemicals or respiratory irritants from hobbies, work, or elsewhere), the odds ratios for CRS were 1.69 (NS) for SHS exposure at home, 2.81 for exposure at work, 1.48 (NS) for exposure in public places, and 2.60 for exposure at private functions. A strong, independent dose-response relationship existed between CRS and the number of venues where SHS exposure occurred (odds ratio per 1 of 4 levels 2.03). Approximately 40.0% of CRS appeared to be attributable to SHS."

The authors concluded: "Exposure to SHS is common and significantly independently associated with CRS. These findings have important clinical and public health implications."

This is good evidence to support prohibition of smoking in public places.

For the full abstract, click here.

Arch Otolaryngol Head Neck Surg 136(4):327-334, April 2010
© 2010 to the American Medical Association
Secondhand Smoke as a Potential Cause of Chronic Rhinosinusitis-A Case-Control Study. C. Martin Tammemagi, Ronald M. Davis, Michael S. Benninger, Amanda L. Holm, Richard Krajenta. Correspondence to Dr. Tammemagi:

Category: R. Respiratory, Z. Social Problems. Keywords: second hand smoke, rhinosinisitis, case-control study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 11 May 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.