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Influence of smoking on asthmatic symptoms and allergen sensitisation in early childhood
S M Tariq1, E A Hakim, S M Matthews
1David Hide Asthma and Allergy Research Centre, St Mary's Hospital, Newport, Isle of Wight PO30 5TG, UK.
Insights
Maternal smoking during pregnancy is linked to childhood asthma symptoms, but not allergen sensitization. This association was primarily observed in children with asthma but no allergies, and diminished by age four.
Area of Science:
- Environmental Health
- Pediatric Allergy and Immunology
- Epidemiology
Background:
- Childhood asthma development is influenced by early life environmental factors beyond genetics.
- Maternal smoking is a suspected contributor to asthma symptoms, yet its role in allergen sensitization remains unclear.
Purpose of the Study:
- To investigate the impact of maternal smoking on the development of asthma and allergen sensitization in children.
- To assess the long-term effects of maternal smoking exposure on respiratory health outcomes in offspring.
Main Methods:
- A birth cohort study followed 1218 children to age 4 years.
- Maternal smoking history was recorded, and children underwent skin prick testing for allergens.
- Statistical analysis assessed the association between maternal smoking and asthma development and sensitization.
Main Results:
- Maternal smoking during pregnancy was associated with low birth weight and shorter breastfeeding duration.
- Asthma symptoms at age 2 were linked to maternal smoking, but this association faded by age 4.
- Maternal smoking was a risk factor for asthma in children with negative skin prick tests, but did not increase overall allergen sensitization.
Conclusions:
- Maternal smoking may contribute to asthma symptoms in early childhood, particularly in non-allergic children.
- Maternal smoking does not appear to increase the risk of developing allergen sensitization by age 4.
- Further research is needed to understand the specific mechanisms linking maternal smoking to childhood asthma.
Background:
Apart from heredity, several early life environmental factors are implicated in the development of childhood asthma. Maternal smoking is believed to increase asthmatic symptoms but its influence on the development of allergen sensitisation is debatable.
Study Design:
A whole population birth cohort was reviewed at ages 1, 2, and 4 years. Of 1218 children seen at 4 years, 981 (80.5%) were skin prick tested with a battery of common food and aeroallergens. Smoking history was recorded at birth and updated at each follow up and its impact on the development of asthma and allergen sensitisation in the children was assessed.
Results:
Two hundred and fifty mothers smoked during pregnancy (20.5%) and 307 (25.2%) after childbirth. Maternal smoking in pregnancy was associated with low birth weight (mean (SD): 3.3 (0.5) v. 3.5 (0.5) kg; p<0.001). Smoking mothers were more often from lower social classes (31.8% v. 16%, p<0. 001) and they breast fed their babies for a shorter duration (8.5 (11.4) v. 16.6 (15.2) weeks; p<0.001). The difference in breast feeding duration was partly due to a higher proportion of smoking mothers who never breast fed their babies. Although at age 2 years asthmatic symptoms were associated with exposure to maternal tobacco smoke (odds ratio 2.2, 95% confidence interval 1.5 to 3.4; p<0.001), this association was lost by 4 years. However, maternal smoking was a significant risk factor in a subgroup of children with asthmatic symptoms but negative skin prick test. Maternal smoking did not increase allergen sensitisation at age 4 years. No effect of paternal smoking on asthma was observed in the children.
Related Concept Videos
Asthma: Pathogenesis and Management
Asthma is classified as allergic and non-allergic. Allergens such as dust mites, pollen, and pet dander trigger allergic asthma, while factors like cold air, intense emotions, or exercise can induce non-allergic asthma.
Asthma-I: Introduction
Asthma-II: Pathophysiology and Classification
Additionally, environmental and genetic factors play crucial roles in determining an individual's susceptibility to asthma and the severity of their condition.
Critical processes in asthma pathophysiology include:
Asthma-III: Symptoms and Complications
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Asthma I: Introduction
Asthma III: Clinical Manifestations

