title: Smoking, environmental tobacco smoke, and aspirin-exacerbated respiratory disease.
abstract: BACKGROUND
  Tobacco smoke is a widely recognized environmental pollutant and is a major public health hazard worldwide. Although environmental tobacco smoke (ETS) has a clear link with many conditions, including asthma, ear infections, and sinus cancer, evidence related to aspirin-exacerbated respiratory disease (AERD) requires further investigation.
  
  
  OBJECTIVE
  To investigate whether active smoke or ETS exposures are associated with an increased risk of developing AERD.
  
  
  METHODS
  A total of 260 patients with AERD were enrolled in a case-control study with their respective asymptomatic spouses serving as matched controls. Multiple logistic regression analysis was used to examine the association of AERD with active smoking and ETS, adjusted for age, sex, and location of childhood residence.
  
  
  RESULTS
  The AERD case patients were more likely to have ever smoked actively when compared with controls (odds ratio [OR], 1.54; 95% confidence interval [CI], 1.04-2.28). A significant association (OR, 3.46; 95% CI, 2.22-5.39) was found between childhood ETS exposure and AERD. If a patient was exposed to ETS during both childhood and adulthood, results showed an OR of 5.09 for developing AERD (95% CI, 2.75-9.43). However, no statistically significant association between AERD and ETS only during adulthood was found (OR, 1.60; 95% CI, 0.75-3.40), suggesting that the combined effect of childhood and adulthood ETS may be augmented by the prior childhood exposure.
  
  
  CONCLUSIONS
  Active smoking and childhood ETS exposure are associated with increased odds of developing AERD. In particular, combined childhood and adulthood exposure had major effects. This study suggests that ETS is at least one contributor to the syndrome of AERD.
authors.affiliation: Scripps Clinic, La Jolla, California. Electronic address: Chang.Jinny@scrippshealth.org.
authors.forename: Jinny E
authors.initials: JE
authors.lastname: Chang
authors.affiliation: University of California, San Diego.
authors.forename: Ding
authors.initials: D
authors.lastname: Ding
authors.affiliation: Arquitecto Marcide Hospital, Ferrol, Spain.
authors.forename: Joaquin
authors.initials: J
authors.lastname: Martin-Lazaro
authors.affiliation: Scripps Clinic, La Jolla, California.
authors.forename: Andrew
authors.initials: A
authors.lastname: White
authors.affiliation: Scripps Clinic, La Jolla, California.
authors.forename: Donald D
authors.initials: DD
authors.lastname: Stevenson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001241:Aspirin / Q000009:adverse effects; D055963:Asthma, Aspirin-Induced / Q000209:etiology*; D016022:Case-Control Studies; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012140:Respiratory Tract Diseases / Q000139:chemically induced / Q000209:etiology; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D014028:Tobacco Smoke Pollution / Q000009:adverse effects*; D055815:Young Adult
chemical_list: D014028:Tobacco Smoke Pollution; D001241:Aspirin