title: High smoking cessation rate in Crohn's disease patients after physician advice--the TABACROHN Study.
abstract: BACKGROUND
  Tobacco smoking has a significant impact on the development of Crohn's disease (CD) and its clinical course, making smoking cessation one of the main goals in CD therapeutic strategy.
  
  
  OBJECTIVE
  To evaluate the effectiveness of an advice-based smoking cessation strategy among CD patients.
  
  
  METHODS
  We have performed a prospective multicenter study which enrolled 408 CD smokers. At inclusion all patients were instructed about the risks of smoking and subsequently followed every 3 months. Each center used additional smoking cessation strategies based on available resources. Urinary cotinine and exhaled carbon monoxide levels were evaluated in a subgroup of patients.
  
  
  RESULTS
  Median study follow up was 18 months. 31% of the patients achieved complete smoking cessation and 23% were smoking-free at the end of their follow up with 8% of smoking relapse. Most patients not achieving smoking cessation did not change their smoking habit with only 5% presenting a decrease in tobacco load. 63% of patients willing to quit smoking received help from another specialist, most frequently the pulmonologist (47%). Surprisingly, most patients (88%) tried to quit smoking with no pharmacological therapy and bupropion, varenicline and nicotine replacement treatment were used in few patients. Urinary cotinine and exhaled CO levels tested in a subgroup of patients proved to have a good correlation with the self-reported smoking habit. No predictors of successful smoking cessation were identified.
  
  
  CONCLUSIONS
  Our results underline that an anti-tobacco strategy mostly based on CD patients's education and counseling is feasible and effective in helping patients reach complete abstinence.
authors.affiliation: Hospital Clinic/IDIBAPS, Barcelona, Spain.
authors.forename: Tiago
authors.initials: T
authors.lastname: Nunes
authors.forename: Maria Josefina
authors.initials: MJ
authors.lastname: Etchevers
authors.forename: Olga
authors.initials: O
authors.lastname: Merino
authors.forename: Sonia
authors.initials: S
authors.lastname: Gallego
authors.forename: Valle
authors.initials: V
authors.lastname: García-Sánchez
authors.forename: Ignacio
authors.initials: I
authors.lastname: Marín-Jiménez
authors.forename: Luis
authors.initials: L
authors.lastname: Menchén
authors.forename: Manuel
authors.initials: M
authors.lastname: Barreiro-de Acosta
authors.forename: Guillermo
authors.initials: G
authors.lastname: Bastida
authors.forename: Sara
authors.initials: S
authors.lastname: García
authors.forename: Elena
authors.initials: E
authors.lastname: Gento
authors.forename: Daniel
authors.initials: D
authors.lastname: Ginard
authors.forename: Eva
authors.initials: E
authors.lastname: Martí
authors.forename: Fernando
authors.initials: F
authors.lastname: Gomollón
authors.forename: Maite
authors.initials: M
authors.lastname: Arroyo
authors.forename: David
authors.initials: D
authors.lastname: Monfort
authors.forename: Esther
authors.initials: E
authors.lastname: García-Planella
authors.forename: Benito
authors.initials: B
authors.lastname: Gonzalez
authors.forename: Carme
authors.initials: C
authors.lastname: Loras
authors.forename: Carles
authors.initials: C
authors.lastname: Agustí
authors.forename: Carolina
authors.initials: C
authors.lastname: Figueroa
authors.forename: Miquel
authors.initials: M
authors.lastname: Sans
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000209:etiology*; D037001:Directive Counseling; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011446:Prospective Studies; D012907:Smoking / Q000009:adverse effects / Q000628:therapy*; D016540:Smoking Cessation / Q000379:methods* / Q000706:statistics & numerical data; D016896:Treatment Outcome