Highlights
- •Nine studies provided data for meta-analysis (n = 40,685 participants).
- •Current smokers were 5 times more likely to have laboratory-confirmed influenza than non-smokers.
- •Current smokers were 34% more likely to develop an influenza-like illness than non-smokers.
Abstract
Objectives
The association of current smoking with influenza infection is not widely recognised.
The aim of this systematic review was to summarise published evidence and quantify
the risk of influenza infection in tobacco smokers compared to non-smokers.
Methods
We systematically searched MEDLINE, EMBASE, CINAHL, LILACS and Web of Science, from
inception to 7 November 2017, to identify relevant randomised control trials, cohort
and case-control studies. Study quality was assessed using the Newcastle–Ottawa Scale.
We included studies defining influenza as a clinical syndrome and those using confirmatory
microbiological tests. Pooled odds ratios (ORs) were estimated by using random effects
model.
Results
The mean quality score across the nine included studies (n = 40,685 participants) was 5.4 of 9 (SD 1.07). Current smokers were over 5 times
more likely to develop laboratory-confirmed influenza than non-smokers (pooled OR
5.69 (95% CI 2.79–11.60), 3 studies). For studies reporting the occurrence of an influenza-like
illness (ILI), current smokers were 34% more likely to develop ILI than non-smokers
(pooled OR 1.34 (95% CI 1.13–1.59), 6 studies).
Conclusion
Current smokers have an increased risk of developing influenza compared to non-smokers.
The association was strongest in studies examining cases with laboratory confirmed
influenza.
Keywords
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Article info
Publication history
Published online: August 26, 2019
Accepted:
August 22,
2019
Identification
Copyright
© 2019 The British Infection Association. Published by Elsevier Ltd. All rights reserved.
