Tobacco Smoke Exposure is Associated with a Distinct Nasal Rhinotype and Respiratory Illnesses in a Pediatric Population

Secondhand tobacco smoke exposure (TSE) can alter immune responses in children and can increase susceptibility to respiratory infections. We hypothesize that TSE modifies the nasal microbiome of children in a dose dependent manner that correlates with cotinine levels. Children with higher cotinine levels had reduced alpha diversity and distinct microbial communities, and inpatients with respiratory conditions had higher cotinine levels. These findings suggest a possible link between altered nasal microbiome diversity from TSE and higher respiratory risk in children. The identified distinct nasal rhinotype may be a potential biomarker for TSE and needs further validation.