title: Smoking and risk of acute and chronic pancreatitis among women and men: a population-based cohort study.
abstract: 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.
authors.affiliation: Center for Alcohol Research, National Institute of Public Health, University of Southern Denmark, Copenhagen K, Denmark. jst@niph.dk
authors.forename: Janne Schurmann
authors.initials: JS
authors.lastname: Tolstrup
authors.forename: Louise
authors.initials: L
authors.lastname: Kristiansen
authors.forename: Ulrik
authors.initials: U
authors.lastname: Becker
authors.forename: Morten
authors.initials: M
authors.lastname: Grønbaek
mesh_terms: 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*