Cigarette Smoking and Risk of Incident Rosacea in Women

Abstract

The relationship between smoking and rosacea is poorly understood. We aimed to conduct the first cohort study to determine the association between smoking and risk of incident rosacea. We included 95,809 women from Nurses' Health Study II (1991-2005). Information on smoking was collected biennially during follow-up. Information on history of clinician-diagnosed rosacea and year of diagnosis was collected in 2005. We used Cox proportional hazards models to estimate age- and multivariable-adjusted hazard ratios and 95% confidence intervals for the association between different measures of smoking and risk of rosacea. During follow-up, we identified 5,462 incident cases of rosacea. Compared with never smoking, we observed an increased risk of rosacea associated with past smoking (multivariable-adjusted hazard ratio = 1.09, 95% confidence interval: 1.03, 1.16) but a decreased risk associated with current smoking (hazard ratio = 0.65, 95% confidence interval: 0.58, 0.72). We further found that increasing pack-years of smoking was associated with an elevated risk of rosacea among past smokers (P for trend = 0.003) and with a decreased risk of rosacea among current smokers (P for trend < 0.0001). The risk of rosacea was significantly increased within 3-9 years since smoking cessation, and the significant association persisted among past smokers who had quit over 30 years before.

Cigarette smoking and risk of rosacea: a nationwide population‐based cohort study

“…A single cohort study from the United States has examined the association between cigarette smoking and the risk of rosacea. 14 This study has found that compared with never smoking, an increased risk of rosacea is associated with past smoking but a decreased risk associated with current smoking. However, the cohort consisted entirely of American female nurses, which might reduce the generalizability of the study's results.…”

“…In addition to the inconsistent results, the case–control design of these studies is subject to several potential sources of bias. A single cohort study from the United States has examined the association between cigarette smoking and the risk of rosacea 14 . This study has found that compared with never smoking, an increased risk of rosacea is associated with past smoking but a decreased risk associated with current smoking.…”

Incidence and prevalence of rosacea: a systematic review and meta-analysis

“…However, there might also exist true sex‐specific differences as seen for migraine, a condition that has been linked to rosacea . Moreover, the overall higher prevalence of male smokers could affect the rosacea prevalence estimates, as a recent study showed that active smoking is associated with a lower prevalence of rosacea, possibly due to vasoconstriction . Ultraviolet irradiation is known to worsen the symptoms of rosacea, and actinic skin damage was shown to be associated with an increased prevalence of rosacea .…”

Alcohol intake and risk of rosacea in US women

“…We examined the association between alcohol intake and risk of rosacea stratified by smoking status 19 . To address the concern of reverse-causation bias, a 4-year lag analysis was conducted by excluding rosacea cases documented within the first four years of each updated assessment of alcohol intake.…”