Smoking and risk of acute and chronic pancreatitis among women and men: a population-based cohort study.
BACKGROUND
Alcohol and gallstone disease are the most established risk factors for pancreatitis. Smoking is rarely considered to be a cause despite the fact that a few studies have indicated the opposite. We aimed to assess the independent effects of smoking on the risk of pancreatitis.


METHODS
We used data from an observational, population-based cohort study conducted in Denmark. Participants were 9573 women and 8332 men who were followed up for a mean of 20.2 years. Participants underwent a physical examination and completed self-administered questionnaires about lifestyle habits. Information on incident cases of acute and chronic pancreatitis were obtained by record linkage with the Danish national registries.


RESULTS
A total of 235 cases of pancreatitis occurred during follow-up. A dose-response association between smoking and risk of acute and chronic pancreatitis was observed in both men and women. For example, the hazard ratio of developing pancreatitis was 2.6 (95% confidence interval [CI], 1.5-4.7) among women and 2.6 (95% CI, 1.1-6.2) among men who smoked 15 to 24 grams of tobacco per day. Alcohol intake was associated with an increased risk of pancreatitis (hazard ratio, 1.09; 95% CI, 1.04-1.14 for each additional drink per day). The risk of pancreatitis associated with smoking, however, was independent of alcohol and gallstone disease. Approximately 46% of cases of pancreatitis were attributable to smoking in this cohort.


CONCLUSIONS
In this population of Danish men and women, smoking was independently associated with increased risk of pancreatitis.
Tolstrup
Janne Schurmann
JS
Center for Alcohol Research, National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark. jst@niph.dk
Kristiansen
Louise
L
Becker
Ulrik
U
Grønbaek
Morten
M
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects; D003718:Denmark / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D042882:Gallstones / Q000150:complications; D006801:Humans; D008297:Male; D008875:Middle Aged; D050500:Pancreatitis, Chronic / Q000209:etiology*; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*