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Published on: April 1, 2022
Prospective Study of Alcohol Drinking, Smoking, and Pancreatitis: The Multiethnic Cohort
Veronica Wendy Setiawan1, Stephen J Pandol, Jacqueline Porcel
1From the *Department of Preventive Medicine, and †Norris Comprehensive Cancer Center, Keck School of Medicine of University of Southern California, Los Angeles, CA; ‡Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center and Department of Veterans Affairs, Los Angeles, CA; §Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI; ∥Memorial Sloan Kettering Cancer Center, New York, NY.
Objectives:
We conducted a prospective analysis of 145,886 participants in the multiethnic cohort to examine the relationship of alcohol drinking and smoking with pancreatitis.
Methods:
Pancreatitis cases were categorized as gallstone-related acute pancreatitis (GSAP) (N = 1,065), non-GSAP (N = 1,222), and recurrent acute (RAP)/chronic pancreatitis (CP) (N = 523). We used the baseline questionnaire to identify alcohol intake and smoking history. Associations were estimated by hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox models.
Results:
Cigarette smoking was associated with non-GSAP and RAP/CP. Moderate alcohol intake was inversely associated with all types of pancreatitis in women (HRs, 0.66 to 0.81 for <1 drink per day), and with RAP/CP in men (HR, 0.57; 95% CI, 0.41-0.79 for <2 drinks per day). The risk of non-GS pancreatitis associated with current smoking was highest among men who consumed more than 4 drinks per day (HR, 2.06; 95% CI, 1.28-3.30), whereas among never smokers, moderate drinking was associated with a reduced risk (HR, 0.70; 95% CI, 0.51-0.96). In women, drinking less than 2 drinks per day was associated with a reduced risk of GSAP among never smokers (HR, 0.61; 95% CI, 0.46-0.80).
Conclusions:
Smoking is a risk factor for non-GS pancreatitis. Moderate alcohol intake is protective against all types of pancreatitis in women and against RAP/CP in men.
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