Article Text
Abstract
Background Smoking has a detrimental effect on Crohn’s disease (CD) while data on ulcerative colitis (UC) are conflicting. Smoking habits have changed dramatically in the UK due to a public smoking ban and the advent of e-cigarettes. We describe current smoking rates in patients with inflammatory bowel disease (IBD) and any effects on disease course.
Methods Self-reported smoking status was elicited in outpatients with IBD, and clinical data were extracted from patient records.
Results Of 465 patients (58% CD, 42% UC), 247 (53.1%) were ever-smokers (37.4% ex-smokers, 15.7% current smokers). Electronic cigarettes (e-cigarettes) were ever used by 28 patients (15 current users). All e-cigarette users had previously smoked cigarettes and 13 had stopped smoking completely. Patients with CD were more likely to currently smoke (21.5% vs 7.7%, p<0.001) than those with UC. Ever use of biological therapy was higher in current smokers compared with never smokers (49% vs 35%, p=0.034). The need for surgery was higher in current smokers compared with never smokers (43% vs 25%, p=0.006). The risk of CD complications during 21-month prospective follow-up was numerically higher for current smoker versus e-cigarette users (53% vs 17%, p=0.19).
Compared with the general population, the proportion of current cigarette smokers (14.9% vs 15.1%) and e-cigarette users was similar in our cohort (4.26% vs 5.5%).
Conclusions Patients with IBD show similar smoking behaviour to the general population. E-cigarettes were used as replacement for cigarettes or by some as an intermediate step for smoking cessation. Larger, prospective studies are required to fully determine the effects of e-cigarettes on IBD.
- ulcerative colitis
- Crohn’s disease
- smoking
- e-cigarettes
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Footnotes
Presented at The study has previously been presented as an abstract at the 13th European Crohn’s and Colitis Organisation Congress 2018 (abstract in J Crohns Colitis) and at the British Society of Gastroenterology Annual Meeting 2018 (abstract in Gut).
Contributors CPS conceived and designed the study, supervised data collection and data analysis and wrote the draft manuscript. CC and AR collected study data, performed the primary analysis and wrote sections of the manuscript draft. RCS and KL collected study data, provided insight into the analysis and critically reviewed the manuscript.
Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement All data relevant to the study are included in the article or uploaded as online supplementary information.