Smoking cessation at the clinical onset of chronic pancreatitis and risk of pancreatic calcifications.
OBJECTIVE
Cigarette smoking is associated with a higher risk of developing chronic pancreatitis (CP) and increases the likelihood of developing pancreatic calcifications. The aim of this study was to know whether smoking cessation modifies the course of the disease.


METHODS
Patients with CP who had been followed up for more than 6 years from clinical onset and who had not developed calcifications after 5 years were analyzed. We studied smokers, never-smokers, and patients who had given up smoking within 5 years. For actuarial analysis, the sixth year was considered as time 0.


RESULTS
Of the 360 patients, there were 43 women and 317 men (88.1%) with a mean age of 38.7 years. The median follow-up was 19.0 years. Chronic pancreatitis was alcohol-associated in 255 patients, hereditary in 10, obstructive in 54, and idiopathic in 41. There were 317 smokers (88.1%) and 259 alcohol drinkers (71.9%). At the end of the follow-up, 212 patients (59.8%) developed calcifications. Concerning the risk of calcifications, never-smokers and ex-smokers had similar actuarial curves, and these were significantly different from the curve for smokers (P < 0.003). Considering never-smokers as the reference class, ex-smokers had an odds ratio (OR) of 0.56 (95.0% confidence interval [CI], 0.2-1.4; P = not significant), patients smoking 1 to 10 cigarettes per day had an OR of 1.95 (95.0% CI, 1.1-3.4; P < 0.019), patients smoking 11 to 20 cigarettes per day had an OR of 1.76 (95.0% CI, 1.1-2.8; P < 0.0018), and those smoking more than 20 cigarettes per day had an OR of 1.79 (95.0% CI, 1.1-2.9; P < 0.019). Alcohol cessation seems to have no influence.


CONCLUSIONS
Smoking cessation in the first years from the clinical onset of CP reduces the risk of developing pancreatic calcifications.
Talamini
Giorgio
G
Gastroenterology and Endoscopy Unit, University of Verona, Verona, Italy. giorgio.talamini@univr.it
Bassi
Claudio
C
Falconi
Massimo
M
Sartori
Nora
N
Vaona
Bruna
B
Bovo
Paolo
P
Benini
Luigi
L
Cavallini
Giorgio
G
Pederzoli
Paolo
P
Vantini
Italo
I
D000206:Actuarial Analysis; D000328:Adult; D017668:Age of Onset; D000428:Alcohol Drinking / Q000009:adverse effects; D002114:Calcinosis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010182:Pancreatic Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control; D050500:Pancreatitis, Chronic / Q000150:complications* / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D013997:Time Factors