Smoking cessation and the course of Crohn's disease: an intervention study.
OBJECTIVE
To evaluate the benefit of smoking cessation in individuals with Crohn's disease, we performed an intervention study in a large cohort of smokers with the disease.


METHODS
Repeated counseling to stop smoking, with easy access to a smoking cessation program, was given to 474 consecutive smokers with Crohn's disease. Patients who stopped smoking for more than 1 year (quitters) were included in a prospective follow-up study, which compared disease course and therapeutic needs with 2 control groups, continuing smokers and nonsmokers, paired for age, gender, disease location, and activity.


RESULTS
There were 59 quitters (12%). Predictors of quitting were the physician, previous intestinal surgery, high socioeconomic status, and in women, oral contraceptive use. During a median follow-up of 29 months (1-54 months), the risk of flare-up in quitters did not differ from that in nonsmokers and was less than in continuing smokers (P < 0.001). Need for steroids and for introduction or reinforcement of immunosuppressive therapy, respectively, were similar in quitters and nonsmokers and increased in continuing smokers. The risk of surgery was not significantly different in the 3 groups.


CONCLUSIONS
Patients with Crohn's disease who stop smoking for more than 1 year have a more benign disease course than if they had never smoked.
Cosnes
J
J
Service de Gastroentérologie et Nutrition, Hôpital Rothschild, 33 Boulevard de Picpus, 75571 Paris cedex 12, France. jacques.cosnes@rth.ap-hop-paris.fr
Beaugerie
L
L
Carbonnel
F
F
Gendre
J P
JP
D000328:Adult; D016022:Case-Control Studies; D003424:Crohn Disease / Q000401:mortality*; D005260:Female; D006801:Humans; D008019:Life Style; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation / Q000706:statistics & numerical data*