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High rates of smoking especially in female Crohn's disease patients and low use of supportive measures to achieve smoking cessation-data from the swiss IBD cohort study


Biedermann, L; Fournier, N; Misselwitz, B; Frei, P; Zeitz, J; Manser, C N; Pittet, V; Juillerat, P; von Känel, R; Fried, M; Vavricka, S R; Rogler, G (2015). High rates of smoking especially in female Crohn's disease patients and low use of supportive measures to achieve smoking cessation-data from the swiss IBD cohort study. Journal of Crohn's & colitis, 9(10):819-829.

Abstract

BACKGROUND AND AIMS Smoking is a crucial environmental factor in inflammatory bowel disease IBD. However, knowledge on patient characteristics associated with smoking, time trends of smoking rates, gender differences and supportive measures to cease smoking provided by physicians is scarce. We aimed to address these questions in Swiss IBD patients. METHODS Prospectively obtained data from patients participating in the Swiss IBD Cohort Study was analysed and compared with the general Swiss population GSP matched by age, sex and year. RESULTS Among a total of 1770 IBD patients analysed 49.1{\%} male, 29{\%} are current smokers. More than twice as many patients with Crohn's disease CD are active smokers compared with ulcerative colitis UC UC, 39.6{\%} vs CD 15.3{\%}, p {\textless} 0.001. In striking contrast to the GSP, significantly more women than men with CD smoke 42.8{\%} vs 35.8{\%}, p = 0.025, with also an overall significantly increased smoking rate compared with the GSP in women but not men. The vast majority of smoking IBD patients 90.5{\%} claim to never have received any support to achieve smoking cessation, significantly more in UC compared with CD. We identify a significantly negative association of smoking and primary sclerosing cholangitis, indicative of a protective effect. Psychological distress in CD is significantly higher in smokers compared with non-smokers, but does not differ in UC. CONCLUSIONS Despite well-established detrimental effects, smoking rates in CD are alarmingly high with persistent and stagnating elevations compared with the GSP, especially in female patients. Importantly, there appears to be an unacceptable underuse of supportive measures to achieve smoking cessation.

Abstract

BACKGROUND AND AIMS Smoking is a crucial environmental factor in inflammatory bowel disease IBD. However, knowledge on patient characteristics associated with smoking, time trends of smoking rates, gender differences and supportive measures to cease smoking provided by physicians is scarce. We aimed to address these questions in Swiss IBD patients. METHODS Prospectively obtained data from patients participating in the Swiss IBD Cohort Study was analysed and compared with the general Swiss population GSP matched by age, sex and year. RESULTS Among a total of 1770 IBD patients analysed 49.1{\%} male, 29{\%} are current smokers. More than twice as many patients with Crohn's disease CD are active smokers compared with ulcerative colitis UC UC, 39.6{\%} vs CD 15.3{\%}, p {\textless} 0.001. In striking contrast to the GSP, significantly more women than men with CD smoke 42.8{\%} vs 35.8{\%}, p = 0.025, with also an overall significantly increased smoking rate compared with the GSP in women but not men. The vast majority of smoking IBD patients 90.5{\%} claim to never have received any support to achieve smoking cessation, significantly more in UC compared with CD. We identify a significantly negative association of smoking and primary sclerosing cholangitis, indicative of a protective effect. Psychological distress in CD is significantly higher in smokers compared with non-smokers, but does not differ in UC. CONCLUSIONS Despite well-established detrimental effects, smoking rates in CD are alarmingly high with persistent and stagnating elevations compared with the GSP, especially in female patients. Importantly, there appears to be an unacceptable underuse of supportive measures to achieve smoking cessation.

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5 citations in Web of Science®
2 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Gastroenterology and Hepatology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2015
Deposited On:20 Nov 2015 10:06
Last Modified:05 Apr 2016 19:31
Publisher:Elsevier
ISSN:1873-9946
Publisher DOI:https://doi.org/10.1093/ecco-jcc/jjv113
PubMed ID:26116554

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