Introduction

Environmental tobacco smoke exposure is a well-established risk factor for paediatric respiratory diseases; however, its role in non-allergic atopic dermatitis during early childhood remains insufficiently defined.

Aim

To evaluate the association between passive tobacco smoke exposure and disease severity in children aged 0–2 years with non-allergic atopic dermatitis.

Material and methods

This prospective observational study with a cross-sectional design included 104 children diagnosed with non-allergic atopic dermatitis between February and April 2025. Passive tobacco smoke exposure was assessed using a structured questionnaire. Disease severity was evaluated using the SCORAD index.

Results

Children exposed to parental smoking had significantly higher SCORAD scores compared to non-exposed children (33.42 ±15.04 vs. 11.64 ±11.78, p < 0.001). Paternal active and passive smoking and postnatal household smoking were significantly associated with increased disease severity. SCORAD scores also differed significantly across exposure-duration categories. Prenatal passive smoke exposure was also associated with higher SCORAD scores, whereas maternal active smoking during pregnancy was not significantly related to disease severity.

Conclusions

Passive tobacco smoke exposure during prenatal and early postnatal periods is associated with increased disease severity in children with non-allergic atopic dermatitis. These findings underline the importance of early preventive measures and family-based smoking cessation strategies in improving dermatological outcomes in early childhood.