title: High Rates of Smoking Especially in Female Crohn's Disease Patients and Low Use of Supportive Measures to Achieve Smoking Cessation--Data from the Swiss IBD Cohort Study.
abstract: OBJECTIVE
  Smoking is a crucial environmental factor in inflammatory bowel disease [IBD]. However, knowledge on patient characteristics associated with smoking, time trends of smoking rates, gender differences and supportive measures to cease smoking provided by physicians is scarce. We aimed to address these questions in Swiss IBD patients.
  
  
  METHODS
  Prospectively obtained data from patients participating in the Swiss IBD Cohort Study was analysed and compared with the general Swiss population [GSP] matched by age, sex and year.
  
  
  RESULTS
  Among a total of 1770 IBD patients analysed [49.1% male], 29% are current smokers. More than twice as many patients with Crohn's disease [CD] are active smokers compared with ulcerative colitis [UC] [UC, 39.6% vs CD 15.3%, p < 0.001]. In striking contrast to the GSP, significantly more women than men with CD smoke [42.8% vs 35.8%, p = 0.025], with also an overall significantly increased smoking rate compared with the GSP in women but not men. The vast majority of smoking IBD patients [90.5%] claim to never have received any support to achieve smoking cessation, significantly more in UC compared with CD. We identify a significantly negative association of smoking and primary sclerosing cholangitis, indicative of a protective effect. Psychological distress in CD is significantly higher in smokers compared with non-smokers, but does not differ in UC.
  
  
  CONCLUSIONS
  Despite well-established detrimental effects, smoking rates in CD are alarmingly high with persistent and stagnating elevations compared with the GSP, especially in female patients. Importantly, there appears to be an unacceptable underuse of supportive measures to achieve smoking cessation.
authors.affiliation: Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland luc.biedermann@usz.ch.
authors.forename: Luc
authors.initials: L
authors.lastname: Biedermann
authors.affiliation: Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Fournier
authors.affiliation: Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Misselwitz
authors.affiliation: Division of Gastroenterology & Hepatology, Seespital Horgen, Horgen, Switzerland.
authors.forename: Pascal
authors.initials: P
authors.lastname: Frei
authors.affiliation: Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Jonas
authors.initials: J
authors.lastname: Zeitz
authors.affiliation: Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Christine N
authors.initials: CN
authors.lastname: Manser
authors.affiliation: Institute of Social and Preventive Medicine, University of Lausanne, Lausanne, Switzerland.
authors.forename: Valerie
authors.initials: V
authors.lastname: Pittet
authors.affiliation: Division of Gastroenterology & Hepatology, Inselspital Bern, Bern, Switzerland.
authors.forename: Pascal
authors.initials: P
authors.lastname: Juillerat
authors.affiliation: Department of Psychosomatic Medicine, Clinic Barmelweid, Barmelweid, Switzerland.
authors.forename: Roland
authors.initials: R
authors.lastname: von Känel
authors.affiliation: Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Michael
authors.initials: M
authors.lastname: Fried
authors.affiliation: Division of Gastroenterology & Hepatology, Triemli Hospital, Zurich, Switzerland.
authors.forename: Stephan R
authors.initials: SR
authors.lastname: Vavricka
authors.affiliation: Division of Gastroenterology and Hepatology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Rogler
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003093:Colitis, Ulcerative / Q000453:epidemiology* / Q000523:psychology*; D003424:Crohn Disease / Q000453:epidemiology* / Q000523:psychology*; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology* / Q000523:psychology; D016540:Smoking Cessation / Q000706:statistics & numerical data*; D000074606:Smoking Prevention; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D013557:Switzerland / Q000453:epidemiology; D055815:Young Adult
keywords: Smoking; gender differences; smoking cessation