OBJECTIVE:To investigate the effects of long-term exposure to moxa smoke on acupuncturists and to consider the association between physical symptoms and gender,age,secondhand smoke (SHS) exposure,and the duration of exposure.METHODS:A self-report,web-based questionnaire was used to evaluate the effects of moxa smoke on acupuncturists.Logistic regression was used to analyze the relationship between physical symptoms and possible correlative factors.RESULTS:A total of 858 questionnaires were analyzed.The data showed that 42.42％ of acupuncturists had been exposed to moxa smoke for 5-10 years.The most frequent symptom was tearing (32.98％) and the least frequent symptom was asthma (5.24％).Logistic regression analysis showed that female acupuncturists were slightly more susceptible to cough and tearing than males (cough:OR:1.583,95％ CI:1.079,2.321,P =0.019;tearing:OR:1.519,95％ CI:1.094,2.108,P=0.013).Acupuncturists aged over 25 years reported a slightly lower incidence of eye itchiness than those aged under 25 years (26-40 years:OR:0.604,95％ CI:0.379,0.965,P =0.035;over 40 years:OR:0.330,95％ CI:0.114,0.958,P =0.042).Ophthalmodynia occurred less in acupuncturists aged 26-40 years (OR:0.591,95％ CI:0.359,0.970,P =0.038) than in those younger than 25 years.The only association between prevalence of symptoms and tobacco use and SHS exposure was that smokers had a lower occurrence of phlegm in the throat (OR:0.579,95％ CI:0.392,0.856,P =0.006).Shortness of breath was less frequent in participants exposed to moxa smoke for more than 5 years (5-10 years:OR:0.400,95％ CI:0.204,0.785,P =0.008;11-20 years:OR:0.392,95％ CI:0.178,0.864,P =0.02),but a slightly higher incidence of eye itchiness was found in those with over 20 years of moxa exposure (OR:4.200,95％ CI:1.344,3.128,P =0.014).CONCLUSION:The most frequent symptom of moxa smoke exposure in acupuncturists was tearing.The association of symptoms with age and duration of exposure to moxa smoke were rather complicated;hence,care should be taken in drawing conclusions about the safety of moxa smoke based solely on its potentially harmful ingredients.