Incidence of Hidradenitis Suppurativa among Tobacco Smokers: a population based retrospective analysis in the United States

Summary

Background

The relationship between tobacco use and hidradenitis suppurativa (HS) is controversial.

Objective

To determine incidence of HS among tobacco smokers.

Methods

Retrospective cohort analysis identifying incident HS cases among adult tobacco smokers and non-smokers sampled from a demographically heterogeneous population-based sample of over 50 million unique patients across all census regions.

Results

We identified 3,924,310 tobacco smokers, among whom were 7,860 patients newly diagnosed with HS. Tobacco smokers diagnosed with HS were most commonly aged 18-39 years (3795/7,860; 48.3%), women (5,640/7,860; 71.8%), Caucasian (5,200/7,860; 66.2%), and those with BMI ≥30 (5,690/7,860; 72.4%). Overall incidence of HS was 0.20% (7,860/3,924,310) among tobacco smokers and 0.11% (8,430/8,027,790) among non-smokers (p< 0.0001). 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%). Overall adjusted odds of developing HS was 1.90 [95% CI 1.84-1.96] among tobacco smokers, compared to non-smokers (p<0.0001). HS incidence among tobacco smokers remained increased within each demographic subgroup.

Conclusions

Incidence of HS appears to be doubled among tobacco smokers. These findings may support evidence-based counseling efforts on cessation of smoking for populations at risk for HS.

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