Background: The relationship between the types of tobacco products and allergic diseases remains unclear. Hence, this study determined whether the current use of tobacco and combination of cigarettes, such as conventional cigarettes (CC), electronic cigarettes (EC), and heated tobacco products (HTP), among Korean adolescents affects the development of allergic diseases. Methods: This cross-sectional study analyzed the data from the 15th Korean Youth Risk Behavior survey. Participants included 55,748 adolescents at the age of 13-18 years. We performed a multivariable logistic regression analysis and calculated odds ratios (ORs) and 95% confidence interval (CI) of having allergic diseases. Results: Asthma, allergic rhinitis, and atopic dermatitis were reported by 1.5%, 20.0%, and 6.4% of the total participants, respectively. The rates of allergic diseases were the highest in EC and HTP users together. After adjusting for confounding variables, adolescents who used only HTP were associated with the highest risks of having asthma (OR, 6.80; 95% CI, 2.28-20.32) and atopic dermatitis (OR, 2.73; 95% CI, 1.11-6.76) compared with those who never used tobacco. Among adolescents who used EC and HTP together, the ORs of allergic rhinitis were the highest (OR, 1.79; 95% CI, 1.04-3.09). Conclusion: The association with increased allergic diseases was relevant in adolescents who smoked, especially those who used combustible cigarette alternatives. We should be vigilant of the use of HTP, CC, and EC, the hazards of which are already known among adolescents.

Asthma, Allergic dermatitis, Atopic dermatitis, Electronic cigarettes, Heated tobacco products, Korean adolescents