Even light smoking ill advised in inflammatory bowel disease patients

MedWire News: Even light smoking aggravates the condition of patients with the inflammatory bowel condition Crohn’s disease, researchers have found.

All patients who smoke, including those who smoke 10 or fewer cigarettes per day, spend more time troubled by disease symptoms than those who do not smoke, report Dr Philippe Seksik (Hôpital Saint-Antoine & Université Pierre et Marie Curie, Paris, France) and team.

They say: “It should be emphasized that, in contrast to cessation, cigarette dose reduction will probably not induce a significant improvement of disease activity or drug requirements.”

The researchers studied 2795 patients with Crohn’s disease, of whom 638 were heavy smokers (more than 10 cigarettes/day), 385 were light smokers (1–10 cigarettes/day) and the remainder were nonsmokers.

The nonsmokers spent 37% of their time troubled by the symptoms of their disease, the team reports in the journal Inflammatory Bowel Diseases. This was significantly increased in smokers, at 46% in light smokers and 48% in heavy smokers, and occurred despite smokers tending to use more drugs to suppress their symptoms than nonsmokers.

Smokers were also significantly more likely to require hospital admission relating to their bowel symptoms, at 15% of each smoking group compared with 12% of nonsmoking patients.

The researchers accounted for the effects of other factors such as age, gender, disease duration and social standing and wealth on patients’ bowel symptoms. But they still found that both heavy and light smoking significantly increased the time that patients were troubled by their symptoms.

“Smoking cessation is a worthwhile objective and should represent a primary goal in Crohn’s disease management,” conclude Dr Seksik and team.

They add: “If one admits that passive smoking corresponds to consumption of up to four–five cigarettes per day, passive smoking should also be considered as harmful in Crohn’s disease.”