Effect of smoking on symptoms of allergic rhinitis

Background: Tobacco smoking is common in patients with allergic rhinitis. Objective: To examine the impact of smoking on allergic rhinitis. Methods: Two cross-sectional studies (performed between March 1, 2002, and February 28, 2003) assessed the impact of tobacco smoking on the symptoms and quality of life of untreated patients with diagnosed allergic rhinitis who had consulted with primary care physicians (472 patients) and specialists (672 patients). Both studies used the same methods and were combined. Rhinitis was classified according to the Allergic Rhinitis and its Impact on Asthma initiative. The European Community Respiratory Health Survey questionnaire on smoking and the disease-specific Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) were used. Results: A total of 20.8% of the patients were smokers and 10.9% were ex-smokers. More than 78% of the patients had moderate to severe symptoms of rhinitis. Fewer patients had moderate to severe nasal pruritus or loss of smell. There appeared to be no significant difference in the severity of nasal symptoms, depending on the smoking status. Moderate to severe nasal obstruction was observed in 78.8% of the nonsmokers, 79.0% of the smokers, and 77.4% of the ex-smokers. Overall and individual domain scores in the RQLQ were not altered by the smoking status. The overall median (25th-75th percentiles) RQLQ score was 2.8 (2.1-3.5) in nonsmokers, 2.7 (2.0-3.5) in smokers, and 2.7 (1.9-3.5) in ex-smokers. Conclusions: In the present study, which was performed with a large number of untreated patients with a diagnosis of allergic rhinitis, smoking was found not to alter nasal symptoms or nasal-specific quality of life. Ann Allergy Asthma Immunol. 2009; 103:195-200.