The effect of chronic cigarette smoking on the response of anogenital wart in male Chinese patients to topical 25% podophyllin therapy

Integrated Treatment Centre, 9/F., Kowloon Bay Health Centre, 9 Kai Yan Street, Kowloon Bay, Kowloon Bay, Hong Kong A prospective study was carried out from December 1998 to May 1999 in two social hygiene clinics in Hong Kong to evaluate the effect of chronic smoking on clinical response of anogenital wart (AGW) to topical 25% podophyllin therapy. Male smokers and non-smokers with newly diagnosed AGW were recruited for the study. Each patient was treated once every five days consecutively for a maximum of five months and assessed monthly for disappearance of AGW. A total of 178 patients were recruited and 155 patients completed the study. Among these 155 patients, 83 (53.6%) were smokers while 72 (46.4%) were non-smokers. At the end of the first two months, 57 non-smokers but only 30 smokers had their lesions cleared. The difference between the smokers and non-smokers in responding to topical 25% podophyllin therapy at two months interval was statistically significant (χ2=29.0, p<0.01). In addition, the association between smoking and susceptibility to AGW was also evaluated. One hundred and ten healthy patients without AGW were served as a control group. A significant association of AGW with chronic cigarette smoking was noted (odds ratio=1.7, confidence intervals=1.05-2.92, p<0.02). We conclude that smokers gave a less favourable response to topical podophyllin treatment compared to the non-smoker counterparts. Further, chronic smokers were more susceptible than non-smokers to development of AGW.