Effects of light smoking consumption on the clinical course of Crohn's disease

✍ Scribed by Philippe Seksik; Isabelle Nion-Larmurier; Harry Sokol; Laurent Beaugerie; Jacques Cosnes

• Publisher: John Wiley and Sons
• Year: 2009
• Tongue: English
• Weight: 152 KB
• Volume: 15
• Category: Article
• ISSN: 1078-0998
• DOI: 10.1002/ibd.20828

✦ Synopsis

Background:

Cigarette smoking is associated with a more severe crohn's disease (cd) course. however, the effect of light consumption is not known. our aim was to characterize the effect of a light tobacco consumption on the course of cd.

Methods:

We analyzed the course of cd during the period 1995-2007 from data collected in 2795 consecutive patients in whom smoking habits were recorded. patients were classified as nonsmokers (n = 1420), light smokers (1-10 cigarettes/day; n = 385), heavy smokers (>10 cigarettes/day; n = 638), and intermittent smokers (change in smoking habits; n = 352). patient-years while smoking were compared to patient-years without smoking. the analyses considered patient-years regarding annual disease activity and therapeutic requirements.

Results:

The percentage of years with active disease was 37% in nonsmokers versus 46% in light smokers (p < 0.001; adjusted hazard ratio 1.30 [1.19-1.43]) and 48% in heavy smokers (p < 0.001; adjusted hazard ratio 1.68 [1.57-1.81]), despite an increased use of immunosuppressants in smokers. hospitalization rates were also increased in both groups of smokers, with 12% in nonsmokers versus 15% in both groups of smokers (p < 0.001 for both comparisons). the annual rate of intestinal resection was 4.5% in nonsmokers, 5.1% in light smokers, and 5.5% in heavy smokers, with a significant difference observed between nonsmokers and heavy smokers only (p < 0.01).

Conclusions:

Light smokers are doing worse than nonsmokers regarding disease activity and the need for immunosuppressants. complete smoking cessation should be advised in all smokers with cd.