Smoking cessation reduces relapse risk in patients with Crohn's disease
Patients with Crohn’s disease who continued to smoke had an increased risk of disease relapse compared with patients who quit smoking, and those who quit had a similar rate of relapse as nonsmokers.
“The present study is indeed the second trial to prospectively assess the effect of smoking cessation on CD relapse and the first study to do so in the biologic era,” the researchers wrote.
In a multicenter prospective cohort study of 573 patients with CD, researchers investigated tobacco smoking and its association with clinical relapse, as well as the benefits of quitting. All patients in this study were in clinical remission and had various smoking habits, and all smokers were advised to quit.
Median follow-up time for examining disease outcome was 3.25 years, and patients fell into the following categories: nonsmokers (n = 190), former smokers (n = 160), continuing smokers (n = 148) and patients who quit smoking (n = 75).
Multivariate analysis showed smoking was an independent predictor for disease relapse (HR = 1.58; 95% CI, 1.2-2.09). Patients who continued to smoke had a greater incidence of relapse compared to nonsmokers (HR = 1.53; 95% CI, 1.1-2.17), and nonsmokers had similar relapse rates to those who had quit and to those who were former smokers. Compared with nonsmokers, continuing smokers also had double the ratio of hospitalizations and shorter time to require steroid therapy.
Furthermore, continuing smokers had earlier relapse (when evaluated in a time-dependent analysis) whether or not they had been prescribed anti-TNF or immunosuppressant drugs.
“Currently, CD patients are still unaware of the risk related to their smoking habit. Even when the awareness is higher, very few smokers with CD are properly offered smoking cessation therapy,” the researchers wrote. “Importantly, with no education and in the absence of smoking cessation strategies, very few CD patients quit spontaneously. Recent prospective studies have demonstrated that high smoking cessation rates (ranging from 12% to 37% at 1 year) are possible, and these patients should be effectively informed of the risk and offered educational and therapeutic support to quit or decrease their tobacco consumption.” – by Suzanne Reist
Disclosures: The researchers report no relevant financial disclosures