Confirmations and surprises in the association of tobacco use with sinusitis

Objective: To generate estimates of sinusitis prevalence for adults in association with the use of tobacco or passive smoke exposure. Design: Analysis of data from the Third National Health and Nutrition Examination Survey, 1988-1994. Setting: Sample of the noninstitutionalized civilian population of the United States. Participants: A total of 20 050 adults aged 17 years or older. Main Outcome Measurer Presence of self-reported sinusitis or sinus problems. Results: In the United States, 66 million adults, constituting 35% of the adult population, reported having sinusitis or sinus problems at least once during the previous 12 months. Female sex, non-Hispanic white or non-Hispanic black race, higher income levels, and progressively higher educational levels were associated with increased prevalence of sinusitis. The prevalence of both acute and recurrent or chronic sinusitis increased with direct cigarette and other tobacco use but did not rise with passive exposure to cigarette smoke. Conclusions: Consistent with data for other respiratory ailments, the direct use of tobacco confers a small increased risk of developing sinusitis in the adult population, but contrary to expectation, passive smoke does not. The demographic variables of sex, race/ethnicity, and educational level demonstrated unexpectedly strong associations with the prevalence of sinusitis and should be analyzed and controlled for in future studies of sinusitis.