The effect of cigarette smoking on allergic conditions in Maltese children (ISAAC)

Abstract

Maltese children are frequently exposed to tobacco smoke through passive and personal smoking. In the Phase 3 ISAAC study questionnaire, we enquired about passive smoking to the parents of 3816 (80% response rate) 5- to 8-yr-old children and about passive and personal smoking to 4139 (90% response rate) 13- to 15-yr-old participating children. Thirty-one percent of 5- to 8-yr olds were passive smokers with their father more likely to be the smoker (p < 0.0001). Maternal smoking in the first year of the child’s life resulted in the children having an increased chance of wheezing ‘ever’ (p < 0.001), exercise-induced wheezing (p < 0.05) and being diagnosed with asthma (p < 0.0001). Current smoking by the mother also led to the child having current rhinitis (p < 0.001). Fifty-one percent of 13- to 15-yr olds were passive smokers again with the father more likely to be the smoker (p < 0.0001). Maternal (p < 0.0001) and paternal smoking (p < 0.05) resulted in the children having an increased chance of wheezing sometime in their life, exercise induced wheezing, nocturnal cough, and being diagnosed with asthma. Current smoking by the mother was more common in children having current rhinitis (p < 0.05), while current smoking by both mother and/or father led to itchy/watery eyes accompanying rhinitis (p < 0.05). Recurrent itchy rashes were also more likely in passive smokers (p < 0.001). Personal smoking by the 13- to 15-yr olds (8.15% boys vs. 8.8% girls ns ) resulted in a higher cumulative prevalence of wheezing (p < 0.0001), rhinitis (p < 0.05), and recurrent itchy rash (p < 0.001) but only affected current prevalence of wheezing (p < 0.0001). These smokers were more likely to experience exercise-induced wheezing (p < 0.0001), nocturnal cough (p < 0.0001), and being diagnosed with asthma (p < 0.05) and eczema (p < 0.001). Children smoking more than 10 cigarettes/day persisted with wheezing (p = 0.04) had more frequent episodes of exercise-induced wheeze (p = 0.04), nocturnal cough (p < 0.0001), and rhinoconjunctivitis (p = 0.02) than milder smokers. Smoking seems to be affecting childhood allergies in Maltese children quite significantly.