Association of Cotinine-Verified Cigarette Exposure with Chronic Rhinosinusitis in Korean Adults

Abstract

Chronic rhinosinusitis is known to be influenced by cigarette exposure; however, this relationship is based on the presence of nasal polyps, and objective measurements of cigarette exposure in chronic rhinosinusitis are not well established. This study aimed to estimate the association between chronic rhinosinusitis and smoking status based on self-reported questionnaires and urinary cotinine levels according to the presence of nasal polyps. We analyzed a total of 23,621 participants who participated from the fifth Korea National Health and Nutrition Examination Survey (2010-2012). Serum total and specific IgE level were measured. Higher prevalence of chronic rhinosinusitis with nasal polyps was associated with current smoking status (OR = 1.43, 95% CI = 1.00-2.03). This association was prevalent in participants aged <= 50 years (OR = 1.76, 95% CI = 1.01-3.05), and higher urinary cotinine level showed correlation with higher prevalence of chronic rhinosinusitis with nasal polyps in this age group (OR = 1.04, 95% CI = 1.00-1.08). In addition, positive correlation between serum total IgE and urinary cotinine levels was greater in patients with chronic rhinosinusitis (beta = 0.493, 95% CI = 0.071-0.916) than in controls (beta = 0.062, 95% CI = 0.021-0.103). Aggressive smoking interventions should be performed in patients with chronic rhinosinusitis with nasal polyp, especially in cases of young adults or high serum IgE levels.