Tobacco sensitivity in the allergic population: a review with results of desensitization with 10 percent whole leaf tobacco extract.

Tobacco sensitivity is seen in atopic patients who are non-smokers but who have clinical symptoms on exposure to tobacco smoke. It is estimated that 8,000,000 persons with common allergies are also clinically sensitive to tobacco. Females outnumber males by about 4:1 and children are affected as well as adults. The specificity of tobacco sensitivity in 16 atopic patients is confirmed in this study by positive skin reactions, passive transfer and gel diffusion studies. Further purification studies, using saline extracts of cured tobacco leaves, has shown the active antigenic material in tobacco to be a glycoprotein, with molecular weight of 18,000 and other known physical and chemical characteristics including amino acid analysis. The results of desensitization with 10% whole leaf tobacco extract in a larger series of 100 tobacco sensitive patients is discussed. The criteria for making the diagnosis of specific clinical tobacco sensitivity is outlined.