Crohn's disease and smoking: is it ever too late to quit?
نویسندگان
چکیده
BACKGROUND Smoking increases CD risk. The aim was to determine if smoking cessation at, prior to, or following, CD diagnosis affects medication use, disease phenotypic progression and/or surgery. METHODS Data on CD patients with disease for ≥5 yrs were collected retrospectively including the Montreal classification, smoking history, CD-related abdominal surgeries, family history, medication use and disease behaviour at diagnosis and the time when the disease behaviour changed. RESULTS 1115 patients were included across six sites (mean follow-up-16.6 yrs). More non-smokers were male (p=0.047) with A1 (p<0.0001), L4 (p=0.028) and perianal (p=0.03) disease. Non-smokers more frequently received anti-TNF agents (p=0.049). (p=0.017: OR 2.5 95%CI 1.18-5.16) and those who ceased smoking prior to diagnosis (p=0.045: OR 2.3 95%CI 1.02-5.21) progressed to complicated (B2/B3) disease as compared to those quitting at diagnosis. Patients with uncomplicated terminal ileal disease at diagnosis more frequently developed B2/B3 disease than isolated colonic CD (p<0.0001). B2/B3 disease was more frequent with perianal disease (p<0.0001) and if i.v. steroids (p=0.004) or immunosuppressants (p<0.0001) were used. 49.3% (558/1115) of patients required at least one intestinal surgery. More smokers had a 2nd surgical resection than patients who quit at, or before, the 1st resection and non-smokers (p=0.044: HR=1.39 95%CI 1.01-1.91). Patients smoking >3 cigarettes/day had an increased risk of developing B2/B3 disease (p=0.012: OR 3.8 95%CI 1.27-11.17). CONCLUSION Progression to B2/B3 disease and surgery is reduced by smoking cessation. All CD patients regardless of when they were diagnosed, or how many surgeries, should be strongly encouraged to cease smoking.
منابع مشابه
Cigarettes and Gastrointestinal Disorders
Background and Objectives: Smoking is an important risk factor for gastrointestinal disorders such as peptic ulcer, Crohn's disease and various cancers. The present study discusses the most important and known effects of smoking on the gastrointestinal tract. Method and Materials: This review uses the keywords Smoking, Gastrointestinal diseases, Inflammation and Cancer in the English database...
متن کاملPrediction of smoking cessation based on severity of nicotine withdrawal syndrome
Introduction: Smoking cessation at any age is the most effective way to reduce disease progression especially in pulmonary disorders (COPD). Understanding the barriers against successful quit can increase efficacy of smoking cessation programs. It seems that one of the barriers is the experience of nicotine withdrawal syndrome. In this study we evaluated the relationship between successfu...
متن کاملTobacco Quit Rates among Youth in an Urban Health Centre of Mumbai: A Cross Sectional Study
Background: Tobacco use is a major cause of preventable death and disease in India. A nationally representative case-control study of smoking in India (2008) revealed that only 2% of smokers had spontaneously quit. This study was undertaken to assess tobacco quit rates among the youth in an urban health center and to determine barriers in quitting tobacco use. Methods: This cross sectional stud...
متن کاملThe Impact of Smoking Cessation Training-Counseling Programs on Success of Quitting Smoking in Patients with Acute Coronary Syndrome
Background: The smokers who use supportive programs have a greater chance to quit smoking. Smoking cessation recommendation is one of the most important prevention and treatment methods mentioned in care guidelines provided for patients with acute coronary syndrome. Aim: The main objective of this study is to determine the effects of training-counseling programs on smoking cessation in patients...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Journal of Crohn's & colitis
دوره 7 12 شماره
صفحات -
تاریخ انتشار 2013