title: Higher rates of Clostridium difficile infection among smokers.
abstract: OBJECTIVE
  Cigarette smoking has been shown to be related to inflammatory bowel disease. We investigated whether smoking affected the probability of developing Clostridium difficile infection (CDI).
  
  
  METHODS
  We conducted a longitudinal study of 16,781 older individuals from the nationally representative Health and Retirement Study. Data were linked to files from the Centers for Medicare and Medicaid Services.
  
  
  RESULTS
  Overall, the rate of CDI in older individuals was 220.6 per 100,000 person-years (95% CI 193.3, 248.0). Rates of CDI were 281.6/100,000 person-years in current smokers, 229.0/100,000 in former smokers and 189.1/100,000 person-years in never smokers. The odds of CDI were 33% greater in former smokers (95% CI: 8%, 65%) and 80% greater in current smokers (95% CI: 33%, 145%) when compared to never smokers. When the number of CDI-related visits was evaluated, current smokers had a 75% increased rate of CDI compared to never smokers (95% CI: 15%, 167%).
  
  
  CONCLUSIONS
  Smoking is associated with developing a Clostridium difficile infection. Current smokers have the highest risk, followed by former smokers, when compared to rates of infection in never smokers.
authors: Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, United States of America. maryroge@umich.edu
authors: Mary A M
authors: MA
authors: Rogers
authors: M Todd
authors: MT
authors: Greene
authors: Sanjay
authors: S
authors: Saint
authors: Carol E
authors: CE
authors: Chenoweth
authors: Preeti N
authors: PN
authors: Malani
authors: Itishree
authors: I
authors: Trivedi
authors: David M
authors: DM
authors: Aronoff
mesh_terms: D016360:Clostridioides difficile / Q000472:pathogenicity*; D004761:Enterocolitis, Pseudomembranous / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking; D014481:United States / Q000453:epidemiology