Tobacco smoking and occupational hand eczema severity in a North African adult population: a cross-sectional analytical study

Background Hand Eczema (HE) is one of the most common occupational diseases worldwide. Various lifestyle factors have been implicated in HE; however, the influence of tobacco smoking on the severity of HE has not been well studied. Aim The objective of this study is to investigate a possible association between the severity of HE and tobacco smoking. Methods This cross-sectional analytical study included 150 patients with HE seen at the Dermatology and Allergology Unit of the Occupational Department, Farhat Hached Teaching Hospital, Sousse, Tunisia, over a period of 20 months. Data were collected using a pre-established questionnaire completed during an interview with the patient. Tobacco use was self-reported. The assessment of HE severity was based on the Osnabrück Hand Eczema Severity Index score (OHSI). Multivariate analysis was performed using multiple binary logistic regressions. Independent variables were included in the regression models when their significance level was less than 0.2. Results In total, 150 HE patients met the inclusion criteria. The mean age of our population was 41.05 (10.3) years, with a slight female predominance (51.3% vs. 49.7%) and a sex ratio of 0.94. Almost a third of participants—or 46 (30.9%)—were smokers. The average pack years of cigarette smoking was 18.56 (12.85). The OHSI score indicated severe HE in 97 patients (64.7%). In multivariate analysis, smoking (adjusted OR: 2.83, CI: 0.99–8.14, p = 0.005) and perceived stress (adjusted OR: 1.06, CI: 1 −1.13, p = 0.01) were associated with severe HE. Similarly, having a leisure activity was inversely associated with severe HE (adjusted OR: 0.18, CI: 0.06–0.50, p = 0.001]). Conclusion It is important to consider smoking cessation as an important target in the prevention and management of HE.