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Article Dans Une Revue Inflammatory Bowel Diseases Année : 2009

Effects of light smoking consumption on the clinical course of Crohn's disease.

Résumé

BACKGROUND: Cigarette smoking is associated with a more severe Crohn's disease (CD) course. However, the effect of light consumption is not known. Our aim was to characterize the effect of a light tobacco consumption on the course of CD. METHODS: We analyzed the course of CD during the period 1995-2007 from data collected in 2795 consecutive patients in whom smoking habits were recorded. Patients were classified as nonsmokers (n = 1420), light smokers (1-10 cigarettes/day; n = 385), heavy smokers (>10 cigarettes/day; n = 638), and intermittent smokers (change in smoking habits; n = 352). Patient-years while smoking were compared to patient-years without smoking. The analyses considered patient-years regarding annual disease activity and therapeutic requirements. RESULTS: The percentage of years with active disease was 37% in nonsmokers versus 46% in light smokers (P < 0.001; adjusted hazard ratio 1.30 [1.19-1.43]) and 48% in heavy smokers (P < 0.001; adjusted hazard ratio 1.68 [1.57-1.81]), despite an increased use of immunosuppressants in smokers. Hospitalization rates were also increased in both groups of smokers, with 12% in nonsmokers versus 15% in both groups of smokers (P < 0.001 for both comparisons). The annual rate of intestinal resection was 4.5% in nonsmokers, 5.1% in light smokers, and 5.5% in heavy smokers, with a significant difference observed between nonsmokers and heavy smokers only (P < 0.01). CONCLUSIONS: Light smokers are doing worse than nonsmokers regarding disease activity and the need for immunosuppressants. Complete smoking cessation should be advised in all smokers with CD.

Domaines

Chimie organique

Dates et versions

hal-00657455 , version 1 (06-01-2012)

Identifiants

Citer

Philippe Seksik, Isabelle Nion-Larmurier, Harry Sokol, Laurent Beaugerie, Jacques Cosnes. Effects of light smoking consumption on the clinical course of Crohn's disease.. Inflammatory Bowel Diseases, 2009, 15 (5), pp.734-41. ⟨10.1002/ibd.20828⟩. ⟨hal-00657455⟩
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