Association between Type of Tobacco Use and Allergic Rhinitis and Bronchial Asthma in Adults

Background: Recent studies have shown that heated tobacco products (HTPs) use is associated with allergic diseases, such as allergic rhinitis, atopic dermatitis, or asthma, usually in adolescent studies.Additionally, most HTP users are poly-tobacco users.Therefore, we investigated the prevalence of asthma or allergic rhinitis based on the type of tobacco use in Korean adults.Methods: This study analyzed data from 23,790 adults participating in the Korea National Health and Nutrition Examination Survey 2019-2022.We categorized tobacco use into non-use, ex-use, and three current use (single use, dual use, or triple use of combustible cigarette [CC], HTP, and electronic cigarettes [EC]).We used multivariate logistic regression analysis to assess the risk of asthma or allergic rhinitis based on the type of tobacco use. Results:The study found that the risk of asthma was 1.574 times higher in CC users than in non-CC users, with an adjusted OR (aOR) of 1.574 and 95% confidence interval (CI) of 1.229-2.016.Additionally, the risk of allergic rhinitis was 1.453 times higher in EC users than in non-EC users, with an aOR of 1.453 and 95% CI of 1.149-1.836.However, the association between HTPs and allergic diseases was not proven.Compared to non-users, the risk of asthma was 2.603 times higher (95% CI=1.029-6.582),and the risk of allergic rhinitis was 1.685 times higher (95% CI=1.040-2.730) in triple tobacco users.Conclusion: Our study reveals that triple tobacco use is associated with allergic rhinitis or asthma in Korean adults.Thus, further longitudinal studies are necessary to establish a cause-and-effect relationship.