title: Smoking, drinking, and pancreatitis: a population-based cohort study in Taiwan.
abstract: OBJECTIVE
  In Western population, smoking is a dose-dependent risk factor for pancreatitis, whereas a threshold of 5 drinks per day may exist for alcohol to increase pancreatitis risk. Given ethnic differences in tobacco and alcohol metabolism, we examined the associations between smoking, alcohol, and pancreatitis in Asians.
  
  
  METHODS
  A population-based cohort was assembled using participants of the National Health Interview Survey in Taiwan. Information on drinking and smoking was collected by in-person interview at baseline. Incident cases of pancreatitis were identified through data linkage with National Health Insurance claims database.
  
  
  RESULTS
  During 94,601 person-years of follow-up, 66 incident cases of pancreatitis occurred. Neither current nor ever smoking was associated with the incidence of pancreatitis (adjusted hazard ratio [aHR] 1.13; 95% confidence interval [CI], 0.62-2.06; and aHR, 1.14; 95% CI, 0.63-2.06, respectively). Dose-response analysis also showed no association between smoking and pancreatitis. By contrast, regular (aHR, 3.09; 95% CI, 1.51-6.30) and heavy alcohol drinking (aHR, 6.46; 95% CI, 3.07-13.60) were associated with an increased incidence of pancreatitis compared with abstinence.
  
  
  CONCLUSIONS
  In this Asian population-based cohort, alcohol was associated with pancreatitis in a dose-dependent way, but smoking was not associated with pancreatitis. These results support for ethnic differences in susceptibility to smoking- and alcohol-related pancreatitis.
authors.affiliation: From the *Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei; †Institute of Population Health, National Health Research Institutes, Miaoli County, Taiwan; ‡Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei; and §School of Medicine, Fu Jen Catholic University, New Taipei City, Taiwan.
authors.forename: Hsien-Ho
authors.initials: HH
authors.lastname: Lin
authors.forename: Hsing-Yi
authors.initials: HY
authors.lastname: Chang
authors.forename: Yi-Ting
authors.initials: YT
authors.lastname: Chiang
authors.forename: Ming-Shiang
authors.initials: MS
authors.lastname: Wu
authors.forename: Jaw-Town
authors.initials: JT
authors.lastname: Lin
authors.forename: Wei-Chih
authors.initials: WC
authors.lastname: Liao
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology*; D002769:Cholelithiasis / Q000453:epidemiology; D015331:Cohort Studies; D015897:Comorbidity; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000453:epidemiology* / Q000208:ethnology; D019512:Pancreatitis, Alcoholic / Q000453:epidemiology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D012959:Socioeconomic Factors; D013624:Taiwan / Q000453:epidemiology