[Allergic diseases and smoking].

Cigarette smoking is a major risk to the overall burden of disease in developed countries. Smoking influences disease development, disease outcome and therapeutic success. Cigarettes with low tar, which do less harm, do not exist, nor there is a safe level of smoking. Passive smoking is involuntary inhalation of tobacco smoke. Environmental tobacco smoke is the second most common cause of carcinogen exposure. Passive smoking, whether prenatal or postnatal in children, increases the likelihood of asthma, similar as in adults. Active smoking increases total immunoglobulin E (IgE) level and inflammatory cell infiltration, especially eosinophils. Tobacco smoking increases bronchial hyperreactivity. Clinical picture of asthma in smokers is more severe in terms of symptoms, with more frequent exacerbations and invasive intubation with increased mortality rate than in asthmatics nonsmokers. Smokers have a higher prevalence of allergic rhinitis and atopic dermatitis.