Smoking Behaviour Changes After Diagnosis of Inflammatory Bowel Disease and Risk of All-cause Mortality.

Autor: Hua X; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.; Clinical and Translation Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA., Lopes EW; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.; Clinical and Translation Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA., Burke KE; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.; Clinical and Translation Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA., Ananthakrishnan AN; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.; Clinical and Translation Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA., Richter JM; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA., Lo CH; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA., Lochhead P; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.; Clinical and Translation Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA., Chan AT; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.; Clinical and Translation Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.; Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA., Khalili H; Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.; Clinical and Translation Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.; Immunology Program, Broad Institute of MIT and Harvard, Cbamridge, MA, USA.; Clinical Epidemiology Unit, Karolinska Institutet, Solna, Sweden.
Jazyk: angličtina
Zdroj: Journal of Crohn's & colitis [J Crohns Colitis] 2022 Aug 04; Vol. 16 (7), pp. 1030-1038.
DOI: 10.1093/ecco-jcc/jjac015
Abstrakt: Background and Aims: We examined smoking behaviour changes after diagnoses of Crohn's disease [CD] and ulcerative colitis [UC] and evaluated their impact on mortality.
Methods: Study population included incident CD or UC cases from three cohorts of the Nurses' Health Study [NHS], NHSII, and Health Professionals Follow-up Study. Smoking and other risk factors were prospectively assessed. Smoking behaviour changes were categorised as never, former [i.e., quit smoking before diagnosis], quitters [i.e., quit smoking after diagnosis], and current [i.e., continue smoking after diagnosis]. Follow-up for date and cause of death was completed through linkage to the National Death Index. Cox proportional hazard regression was used to estimate hazard ratios [HRs] and 95% confidence intervals [CIs].
Results: Among 909 eligible CD and UC cases, 45% were never smokers, 38% were past smokers, and 16% were active smokers at the time of diagnosis. Among active smokers, 70% of patients with CD and 44% of patients with UC continued to smoke after diagnosis. In patients with CD, compared with current smokers, the multivariable-adjusted HRs [95% CI] of death were 0.19 [0.10 to 0.38] for never smokers, 0.31 [0.16 to 0.57] for former smokers, and 0.41 [0.18 to 0.93] for quitters. Similarly for UC, compared with current smokers, we observed a reduced risk of mortality for never smokers [HR = 0.23, 95% CI 0.10 to 0.51], former smokers [HR = 0.23, 95% CI 0.11 to 0.48], and quitters [HR = 0.28, 95% CI 0.11 to 0.72].
Conclusions: In three cohorts of health professionals, a substantial proportion of patients with new diagnosis of CD and UC and history of smoking continued to smoke after diagnosis. Smoking cessation around the time of diagnosis was associated with a significant reduction in mortality.
(© The Author(s) 2022. Published by Oxford University Press on behalf of European Crohn’s and Colitis Organisation. All rights reserved. For permissions, please email: journals.permissions@oup.com.)
Databáze: MEDLINE
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