Allergy to Smoke: Myth or Reality

For some people just the sight of smoke is enough to start a long list of symptoms, including blocked nose, sneezing and watery eyes. From the symptoms, you may think that you’re experiencing an allergic reaction and assume you have an allergy to a constituent of the smoke. This article will review current knowledge about the effects of smoke in your respiratory airways.

Can you be allergic to smoke? Is smoke an allergen?

In the early 80s, researchers assumed that smoke triggered an allergic reaction, because rats and rabbits exhibited such response in the presence of smoke. Furthermore, if we look at the plant of tobacco itself, in fact at least 3 allergens have been identified.

However, with further advances in science, it was possible to demonstrate that smoke does not initiate an allergic reaction in humans. Although symptoms may be identical to allergic rhinitis, technically, smoke is not an allergen, but an irritant that causes allergy-like symptoms. Allergens need to be protein-based for the body to recognise it as an intruder, but smoke only contains ash particles from burning the tobacco leaves (with any allergens present destroyed), which are not identified by your body as a true allergen, because they’re not made up of protein.

This is supported by the fact that people experiencing blocked nose and watery eyes after exposure to smoke do not get any relief for their condition with antihistaminic treatments.

What are the symptoms associated with smoke sensitivity?

Those more likely to be affected include children and elderly or those suffering from other allergies or asthma. Also there’s a high probability that you’ll develop this condition, if you’re exposed to smoke for long periods regularly. Symptoms develop almost immediately after exposure to smoke and last for a few hours. These include:
• Cough and sneezes
• Watery eyes
• Nasal congestion
• Headache
• Difficulty breathing
• Post nasal drip

When you’re sensitive to smoke…

If you experience allergy-like symptoms every time you’re exposed to smoke, the treatment you need for your condition is dependent on what triggers your symptoms. There are two possibilities:
• Smoke-induced allergies: In this case, your immune system is weakened by the smoke and you’re more likely to suffer from other allergies
• Nonallergic rhinitis: Similar symptoms to the allergic version, but cannot be treated with antihistamines.

Smoke-induced allergies

It’s been shown that exposure to smoke, either active or passive, can worsen existing allergies because the nasal passageways and respiratory tract are affected, placing extra stress on you immune system. Studies have shown that smoke jeopardises the integrity of the respiratory epithelium (cells lining nose and throat), facilitating the entry of allergens. A small event that would normally not have been a problem, now becomes the trigger for a violent allergic reaction.

In addition, apart from the visible symptoms including chronic rhinitis, sinusitis and even asthma, smokers also have high levels of IgE, which indicates that the body is getting sensitised to allergens present in the environment and is more likely to develop allergies. For example, one of the many irritant compounds in the smoke that can trigger a reaction is benzene, which has been demonstrated to inhibit anti-inflammatory responses in the lung.

You’re more likely to develop smoke-induced allergies if you’re already allergic to other substances, such as mould, pollen or even food. In this case, treatment involves:
• Avoid smoke
• Avoid any allergens, including dust mites and pollen
• If symptoms start to get very strong, check with your doctor if you’ve developed any new allergy

Nonallergic rhinitis (formerly known as vasomotor rhinitis)

The only difference between allergic and nonallergic rhinitis is the trigger, which is a true allergen in the case of allergic rhinitis but it can be a variety of substances, including irritants, in the case of nonallergic rhinitis. In both cases, there is an inflammation of the respiratory airways, with identical symptoms. This makes it difficult to differentiate between the two, making many sufferers believe they’re allergic to smoke. Understanding their condition is essential to find the best treatment, as treatments designed to deal with allergic reactions will not work in this case. There is also a higher incidence of patients suffering from asthma in those sensitive to smoke than those that do not have this condition.

Symptoms develop very quickly after exposure and only minute amounts are required to trigger a response. If you know you’re sensitive to elements with a strong odour, such as perfume, then you’re more likely to be sensitive to smoke.

Treatments include:
• Avoid smoke
• Anti-drip and corticosteroid nasal sprays and oral decongestants may alleviate the symptoms

Parents smoking increase the chances of allergies in the offspring

Recently doctors have issued several warnings, letting parents know of the damage they’re imposing on their children either by smoking during pregnancy or second-hand smoke for their offspring. Tests clearly show that children with parents that smoke have significantly raised IgE levels, which indicates a more active immune system with an increased probability of developing allergies. Worryingly, several studies have also identified a link between asthma in the children and smoking parents. Furthermore, children living with smokers usually experience many more cases of ear and sinus infections, lung problems or many other respiratory conditions.


Although you may say that there is no such thing as “smoke allergy”, the allergy-type symptoms caused by smoke are a real condition that needs medical assistance. You doctor can identify the trigger for your condition and check whether any other allergies are being exacerbated by your smoke sensitivity. This will then allow the establishment of an appropriate treatment specific for your condition.


Adisesh A, Gruszka L, Robinson E, Evans G. Smoking status and immunoglobulin E seropositivity to workplace allergens. Occup Med (Lond). 2011 Jan;61(1):62-4.
Atici A, Güneşer S, Alparslan N, Antmen B, Yilmaz M, Onenli N. Influence of smoke exposure on serum IgE levels of atopic patients. Acta Paediatr Jpn. 1994 Jun;36(3):266-7.
Gangl K, Reininger R, Bernhard D, Campana R, Pree I, Reisinger J, Kneidinger M, Kundi M, Dolznig H, Thurnher D, Valent P, Chen KW, Vrtala S, Spitzauer S, Valenta R, Niederberger V. Cigarette smoke facilitates allergen penetration across respiratory epithelium. Allergy. 2009 Mar;64(3):398-405.
Håkansson K, von Buchwald C, Thomsen SF, Thyssen JP, Backer V, Linneberg A. Nonallergic rhinitis and its association with smoking and lower airway disease: A general population study. Am J Rhinol Allergy. 2011 Jan-Feb;25(1):25-9.
Jonderko G, Końca A, Kwiatek R, Marcisz C, Neumann M. Hypersensitivity to tobacco antigens in smokers and nonsmokers. Allerg Immunol (Leipz). 1982;28(3):187-91.
Keller KF, Doyle RJ. A mechanism for tobacco smoke-induced allergy. J Allergy Clin Immunol. 1976 Mar;57(3):278-82.
Lee CH, Chuang HY, Hong CH, Huang SK, Chang YC, Ko YC, Yu HS. Lifetime exposure to cigarette smoking and the development of adult-onset atopic dermatitis. Br J Dermatol. 2011 Mar;164(3):483-9.
Lehrer SB, Barbandi F, Taylor JP, Salvaggio JE. Tobacco smoke “sensitivity”–is there an immunologic basis? J Allergy Clin Immunol. 1984 Feb;73(2):240-5.
Lehrer SB, McCants M, Aukrust L, Salvaggio JE .Analysis of tobacco leaf allergens by crossed radioimmunoelectrophoresis. Clin Allergy. 1985 Jul;15(4):355-61.
Lehrer SB, Stankus RP, Salvaggio JE. Tobacco smoke sensitivity: a result of allergy? Ann Allergy. 1986 May;56(5):369-81.
Lehrer SB, Wilson MR, Salvaggio JE. Immunogenic properties of tobacco smoke. J Allergy Clin Immunol. 1978 Dec;62(6):368-70.
Lindberg S, Malm L. Comparison of allergic rhinitis and vasomotor rhinitis patients on the basis of a computer questionnaire. Allergy. 1993 Nov;48(8):602-7
Mlinaric A, Popovic Grle S, Nadalin S, Skurla B, Munivrana H, Milosevic M. Passive smoking and respiratory allergies in adolescents. Eur Rev Med Pharmacol Sci. 2011 Aug;15(8):973-7.
Molina C, Aiache JM, Viallier J. Immunological reactions to tobacco. Nouv Presse Med. 1980 Nov 8;9(42):3171-5.
Triggiani M, Loffredo S, Granata F, Staiano RI, Marone G. Modulation of mast cell and basophil functions by benzene metabolites. Curr Pharm Des. 2011 Nov;17(34):3830-5.

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