title: Crohn's disease patients who quit smoking have a reduced risk of reoperation for recurrence.
abstract: BACKGROUND
  Smoking increases the risk of recurrent Crohn's disease (CD).
  
  
  METHODS
  We examined the impact of smoking, quitting smoking, and other factors on reoperation for recurrent CD. We distributed questionnaires to 584 patients from a surgical database whom had undergone a surgical operation for ileocecal CD to assess history of smoking, medical, behavioral, and demographic information.
  
  
  RESULTS
  Two hundred sixty-seven patients completed the questionnaire (46% response). Smokers were more likely to have undergone 1, 2, and 3 reoperations for recurrence at any site (relative incidence rates [RIR] 1.32, 95% confidence interval [CI]: 1.10 to 1.60; RIR 1.55, 95% CI: 1.09 to 2.20; and RIR 1.77, 95% CI: 1.02 to 3.06, respectively) and were more likely to have undergone one reoperation for recurrent ileocecal CD (RIR 1.48, 95% CI: 1.18 to 1.86). Patients who quit smoking were less likely to have undergone 1, 2, and 3 reoperations for recurrence at any site (RIR 0.25, 95% CI: 0.15 to 0.41; RIR 0.30, 95% CI: 0.16 to 0.57; and RIR 0.25, 95% CI: 0.10 to 0.71, respectively) and were less likely to have undergone one reoperation for recurrent ileocecal CD (RIR 0.27, 95% CI: 0.15 to 0.47).
  
  
  CONCLUSIONS
  This study indicates that patients with ileocecal CD who stop smoking reduce the risk of reoperation for recurrent CD.
authors.affiliation: Stanford University School of Medicine, Stanford, CA, USA. williamryan@stanford.edu
authors.forename: William R
authors.initials: WR
authors.lastname: Ryan
authors.forename: Robert N
authors.initials: RN
authors.lastname: Allan
authors.forename: Takayuki
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Michael R B
authors.initials: MR
authors.lastname: Keighley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002140:California / Q000453:epidemiology; D003424:Crohn Disease / Q000453:epidemiology / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012086:Reoperation / Q000706:statistics & numerical data; D012306:Risk; D055502:Secondary Prevention; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation / Q000706:statistics & numerical data; D006113:United Kingdom / Q000453:epidemiology