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Active and passive smoking in childhood is related to the development of inflammatory bowel disease
Suhal S Mahid1, Kyle S Minor, Arnold J Stromberg
1Price Institute of Surgical Research and Section of Colorectal Surgery, Department of Surgery, University of Louisville School of Medicine, Louisville, Kentucky 40292, USA.
Insights
Childhood exposure to tobacco smoke, both active and passive, increases the risk of developing inflammatory bowel diseases (IBD). This finding is significant in Kentucky, a state with high smoking rates and IBD prevalence.
Area of Science:
- Environmental Health
- Gastroenterology
- Epidemiology
Background:
- Kentucky has the highest smoking prevalence in the U.S., with smoking often starting in childhood.
- The state also has a high burden of inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC).
Purpose of the Study:
- To investigate the association between childhood exposure to active and/or passive tobacco smoke and the likelihood of developing IBD.
Main Methods:
- A prospective study included 672 participants: 253 with CD, 177 with UC, and 242 controls.
- Participants completed a modified Behavioral Risk Factor Surveillance Survey including questions on childhood passive smoke exposure.
Main Results:
- Patients with CD and UC were more likely to start smoking regularly by ages 10 and 15, respectively, compared to controls.
- Early smoking initiation (by age 10) was linked to an earlier UC diagnosis.
- CD patients showed higher rates of prenatal smoke exposure (OR, 1.72) and childhood passive smoke exposure (OR, 2.04).
Conclusions:
- Childhood exposure to passive and active tobacco smoke is a significant factor in the development of IBD.
- The high incidence of IBD in Kentucky highlights the critical role of environmental factors in disease etiology.
Background:
The highest prevalence of smoking in the United States is in Kentucky, where smoking typically begins in childhood. The state has many patients who suffer from inflammatory bowel diseases (IBD). The primary aim of this study was to assess whether exposure to active and/or passive tobacco smoke in childhood is related to the likelihood of developing IBD.
Methods:
Recruited into this prospective study were a total of 672 participants (253 patients with Crohn's disease [CD], 177 patients with ulcerative colitis [UC], and 242 controls), all of whom were asked to complete the Behavioral Risk Factor Surveillance Survey modified by the addition of 4 questions on childhood passive smoke exposure.
Results:
Survey response rate was 84%. CD and UC patients were more likely than controls to begin smoking regularly by ages 10 and 15, respectively, suggesting that becoming a regular smoker at a younger age may be associated with a subsequent diagnosis of IBD. Smoking by age 10 was associated with an earlier age at diagnosis with UC, but not with CD. CD patients were more likely than controls to have prenatal smoke exposure (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.1-2.71) and were more likely to have passive smoke exposure during childhood, with 1 or both parents or other household members being smokers (OR, 2.04; 95% CI, 1.28-3.31).
Conclusions:
Passive and active smoke exposure in childhood influences the development of IBD. A high incidence of this disease in a state with a high rate of cigarette smoking underscores the profound role of environmental factors in the etiology of these illnesses.
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Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...