Incidence of hidradenitis suppurativa among tobacco smokers: a population-based retrospective analysis in the U.S.A.

Abstract

The relationship between tobacco use and hidradenitis suppurativa (HS) is controversial. To determine the incidence of HS among tobacco smokers. Retrospective cohort analysis identifying incident HS cases among adult tobacco smokers and nonsmokers sampled from a demographically heterogeneous population-based sample of over 50 million unique patients across all census regions in the U.S.A. We identified 3 924 310 tobacco smokers, which included 7860 patients newly diagnosed with HS. Tobacco smokers diagnosed with HS were most commonly aged 18-39 years (3795 of 7860; 48·3%), women (5640 of 7860; 71·8%), white (5200 of 7860; 66·2%) and those with body mass index (BMI) ≥ 30 (5690 of 7860; 72·4%). Overall incidence of HS was 0·20% (7860 of 3 924 310) among tobacco smokers and 0·11% (8430 of 8 027 790) among nonsmokers (P < 0·001). Incidence was greatest among tobacco smokers who were aged 30-39 years (0·35%), women (0·28%), African Americans (0·46%) and those with BMI ≥ 30 (0·33%). The overall adjusted odds of developing HS was 1·90 (95% confidence interval 1·84-1·96) among tobacco smokers, compared with nonsmokers (P < 0·001). HS incidence among tobacco smokers remained increased within each demographic subgroup. Incidence of HS appears to be doubled among tobacco smokers. These findings may support evidence-based counselling efforts for the cessation of smoking in populations at risk for HS.