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Nonspecific inflammatory bowel disease and smoking
American Journal of Epidemiology
|March 1, 1987
Summary
Cigarette smoking is linked to a lower risk of ulcerative colitis but a significantly higher risk of Crohn's disease. Ex-smoking may increase ulcerative colitis risk, while Crohn's disease risk rises with smoking intensity.
Area of Science:
- Gastroenterology
- Epidemiology
- Public Health
Background:
- Inflammatory bowel disease (IBD) encompasses ulcerative colitis (UC) and Crohn's disease (CD).
- The relationship between cigarette smoking and IBD is complex and warrants further investigation.
Purpose of the Study:
- To investigate the association between cigarette smoking and the risk of developing ulcerative colitis and Crohn's disease.
Main Methods:
- A hospital-based case-control study was conducted.
- Included 124 UC cases, 109 CD cases, and 250 matched controls.
- Assessed smoking status (current, ex-smoker, never smoker) and smoking intensity.
Main Results:
- Current smoking showed a reduced risk for ulcerative colitis (RR=0.5), with risk decreasing as cigarette consumption increased.
- Ex-smokers had an elevated risk of ulcerative colitis (RR=2.7).
- Cigarette smoking was strongly associated with Crohn's disease (RR=4.0 for ever smokers), with risk increasing with smoking intensity and duration.
Conclusions:
- Smoking appears protective against ulcerative colitis, possibly due to early cessation driven by symptoms or a direct protective effect.
- Smoking is a significant risk factor for Crohn's disease, with a dose-response relationship observed.