Does tobacco smoking influence the occurrence of hand eczema?

Summary Background  Tobacco smoking is known to influence various inflammatory skin diseases and an association between tobacco smoking and hand eczema has been proposed in some studies. Objectives  To examine a possible association between reported current tobacco smoking and the occurrence of hand eczema. Subjects and methods  Previously collected questionnaire data on the occurrence of hand eczema in three occupational cohorts and corresponding controls from the general population were studied. The questionnaires used included questions on 1‐year prevalence of hand eczema and questions on smoking habits. For one occupational group, hairdressers and their controls, information on amount of smoking was obtained. Information on age, sex and history of atopy was also available. Results  In total, answers regarding smoking and hand eczema were obtained from 13 452 individuals. Out of 3493 smokers, 437 (12·5%) reported hand eczema compared with 1294 out of 9959 nonsmokers (13·0%) ( P  =   0·51). With regard to the number of cigarettes smoked, 22·6% of the hairdressers smoking more than 10 cigarettes per day reported hand eczema compared with 17·4% of those smoking 0–10 cigarettes per day ( P  =   0·01). Corresponding figures for the controls were 14·5% and 11·7%, respectively ( P  =   0·06). Conclusions  No clear association was found between 1‐year prevalence of hand eczema and smoking. Heavy smoking, more than 10 cigarettes per day, may give a slightly increased risk of hand eczema. Further studies with information on the amount of tobacco consumption and on possible confounders are needed to evaluate smoking as a risk factor for hand eczema.