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Research suggests that second-hand smoke can: Increase nasal mucosal inflammation , potentially heightening sensitivity to other allergens such as pollen or pet dander Impair mucociliary clearance , the nose's natural mechanism for trapping and expelling irritants Elevate total and specific IgE levels , which may indicate a heightened allergic response Damage epithelial barrier function , potentially allowing allergens to penetrate nasal tissue more easily Worsen existing congestion and rhinorrhoea (runny nose) in sensitised individuals For those living or working in London, where shared indoor environments from offices to public transport can expose individuals to residual smoke particles (sometimes referred to as "third-hand smoke"), awareness of these effects can be particularly relevant

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Strengths The strengths of the study were the long follow-up, which was almost complete, and the ability to adjust for several risk factors and look at several causes of death