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Agache, I.* ; Ricci-Cabello, I.* ; Canelo-Aybar, C.* ; Annesi-Maesano, I.* ; Cecchi, L.* ; Biagioni, B.* ; Chung, K.F.* ; D'Amato, G.* ; Damialis, A.* ; Del Giacco, S.* ; De las Vecillas, L.* ; Dominguez-Ortega, J.* ; Galán, C.* ; Gilles, S.* ; Giovannini, M.* ; Holgate, S.* ; Jeebhay, M.* ; Nadeau, K.* ; Papadopoulos, N.G.* ; Quirce, S.* ; Sastre, J.* ; Traidl-Hoffmann, C. ; Walusiak-Skorupa, J.* ; Salazar, J.* ; Sousa-Pinto, B.* ; Colom, M.* ; Fiol-deRoque, M.A.* ; Gorreto López, L.* ; Malih, N.* ; Moro, L.* ; Pardo, M.G.* ; Pazo, P.G.* ; Campos, R.Z.* ; Saletti-Cuesta, L.* ; Akdis, M.* ; Alonso-Coello, P.* ; Jutel, M.* ; Akdis, C.A.*

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.

Allergy, DOI: 10.1111/all.16151 (2024)
DOI PMC
Free by publisher: Publ. Version/Full Text online available 06/2026
To 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).
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Publication type Article: Journal article
Document type Scientific Article
Corresponding Author
Keywords Grade ; Asthma ; Guideline ; Systematic Review ; Tobacco Smoke; Maternal Smoking; Lung-function; Parental Smoking; Passive Smoking; Postnatal Exposure; In-utero; Risk-factors; 1st Year; Respiratory Symptoms; Airway Inflammation
ISSN (print) / ISBN 0105-4538
e-ISSN 1398-9995
Journal Allergy
Publisher Wiley
Publishing Place 111 River St, Hoboken 07030-5774, Nj Usa
Non-patent literature Publications
Reviewing status Peer reviewed
Institute(s) Institute of Environmental Medicine (IEM)