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BMJ 2003;327:55760
Similar trends were observed for both females and males, with an initial significant decline followed by a significant increase in average daily consumption
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However, certain patterns may suggest that environmental smoke or vapour exposure is playing a role: Symptoms that worsen specifically in smoky or vape-heavy environments Nasal congestion that persists indoors but improves in fresh air Itchy, watery eyes accompanied by repeated sneezing after passive exposure Symptoms that do not follow a clear seasonal pattern, suggesting perennial or environmental triggers A noticeable increase in nasal symptoms despite avoiding known allergens like pollen or dust If you recognise these patterns, an allergy blood test may help clarify whether an underlying allergic sensitisation is present alongside environmental irritant exposure
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