ORIGINAL ARTICLE Parental smoking and allergic rhinitis in children Maryam Salehi, MD 1 , Mehdi Bakhshaee, MD 3 , Sara Jafari Ashtiani, MD 4 , Mona Najafi, MD 2 , Samineh Sehatbakhsh, MD 4 and Mana Hossainzadeh, MD 4 Background: Parental smoking is one of the controversial risk factors associated with allergic rhinitis. The aim of this study was to investigate the relationship between parental smoking and allergic rhinitis; considering confounding factors. Methods: A cross-sectional study was conducted on 671 children aged 2 to 7 years. Random cluster sampling was used to select the participants. The signs and symptoms of allergic rhinitis in children were assessed through standard questionnaires and physical examinations. Results: In the multivariate analysis, parental smoking (odds ratio [OR] 1.07; 95% confidence interval [CI], 0.48– 2.41) was not a significant risk factor for allergic rhinitis; pos- itive family history of allergy was the only significant factor among other factors (OR 23.64; 95% CI, 11.63–48.04). Sex (OR 1.16; 95% CI, 0.60–2.24), family size (OR 1.06; 95% CI, 0.22–5.05), family income (OR 0.60; 95% CI, 0.24–1.47), and parents’ education (OR 1.79; 95% CI, 0.61–5.20) were not statistically significant. Conclusion: The findings suggest that there is no significant relationship between parental smoking and allergic rhinitis. C  2014 ARS-AAOA, LLC. Key Words: allergic rhinitis; smoking; passive smoking; parental smok- ing; children How to Cite this Article: Salehi M, Bakhshaee M, Jafari Ashtiani S, Najafi M, Sehat- bakhsh S, Hossainzadeh M. Parental smoking and allergic rhinitis in children. Int Forum Allergy Rhinol. 2014;4:357– 360. A llergic rhinitis is not a life-threatening disease in chil- dren; however, it has a considerable impact on their quality of life, as well as that of their caretakers. Allergic rhinitis also imposes a substantial economic burden on so- ciety. These children often have difficulty completing their schoolwork, as a result of the early onset of symptoms, usually beginning before school age. 1–3 There has been an increase in the prevalence of allergic rhinitis, 4 with 0.8% to 1 Immunology Research Center, Mashhad University of Medical Sciences and Assistant Professor of Community Medicine, Community Medicine Department, Faculty of Medicine, Mashhad, Iran; 2 Department of Community Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; 3 Sinus and Surgical Endoscopic Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; 4 Sinus and Surgical Endoscopic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran Correspondence to: Mehdi Bakhshaee, MD, Associate professor of the Sinus and Surgical Endoscopic Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran; e-mail: mehbakhsh@yahoo.com Potential conflict of interest: None provided. Received: 11 August 2013; Revised: 22 November 2013; Accepted: 7 December 2013 DOI: 10.1002/alr.21286 View this article online at wileyonlinelibrary.com. 39.7% of children affected in various parts of the world. 5 Complications include otitis media with effusion, hypertro- phy of adenoids, and asthma, all of which require treatment in children. 2 According to a recent systematic review, 67% of research articles have found a significant relationship between sleep-disordered breathing and allergic rhinitis in children. 6 Some risk factors such as family history of allergy are well known, but there are also some controversial risk fac- tors associated with this disease. The risk factors include: parental smoking, sex, nutrition, living area, 3 and socioe- conomic status. 7 A number of studies have investigated the effects of parental smoking on allergic rhinitis. About 43% of children between the ages of 2 to 11 years are exposed to tobacco smoke in the environment. 8 Increased risk of allergic rhinitis has been shown among infants who were exposed to more than 20 cigarettes daily. 8 In another study in Sweden, passive exposure to tobacco smoke at an early age was associated with increased reports of allergic symp- toms. Children who had a family history of allergy and were exposed to cigarette smoke, were more at risk of allergic rhinitis. 9 However, other studies have yielded contradicting results. For example, a study conducted in Istanbul discov- ered there was no association between allergic rhinitis in children aged 6 to 12 and exposure to cigarette smoke. 5 357 International Forum of Allergy & Rhinology, Vol. 4, No. 5, May 2014