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Smoking, drinking, and pancreatitis: a population-based cohort study in Taiwan
Hsien-Ho Lin1, Hsing-Yi Chang, Yi-Ting Chiang
1From the *Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei; †Institute of Population Health, National Health Research Institutes, Miaoli County, Taiwan; ‡Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei; and §School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
Objectives:
In Western population, smoking is a dose-dependent risk factor for pancreatitis, whereas a threshold of 5 drinks per day may exist for alcohol to increase pancreatitis risk. Given ethnic differences in tobacco and alcohol metabolism, we examined the associations between smoking, alcohol, and pancreatitis in Asians.
Methods:
A population-based cohort was assembled using participants of the National Health Interview Survey in Taiwan. Information on drinking and smoking was collected by in-person interview at baseline. Incident cases of pancreatitis were identified through data linkage with National Health Insurance claims database.
Results:
During 94,601 person-years of follow-up, 66 incident cases of pancreatitis occurred. Neither current nor ever smoking was associated with the incidence of pancreatitis (adjusted hazard ratio [aHR] 1.13; 95% confidence interval [CI], 0.62-2.06; and aHR, 1.14; 95% CI, 0.63-2.06, respectively). Dose-response analysis also showed no association between smoking and pancreatitis. By contrast, regular (aHR, 3.09; 95% CI, 1.51-6.30) and heavy alcohol drinking (aHR, 6.46; 95% CI, 3.07-13.60) were associated with an increased incidence of pancreatitis compared with abstinence.
Conclusions:
In this Asian population-based cohort, alcohol was associated with pancreatitis in a dose-dependent way, but smoking was not associated with pancreatitis. These results support for ethnic differences in susceptibility to smoking- and alcohol-related pancreatitis.
