title: Prospective Study of Alcohol Drinking, Smoking, and Pancreatitis: The Multiethnic Cohort.
abstract: We conducted a prospective analysis of 145,886 participants in the multiethnic cohort to examine the relationship of alcohol drinking and smoking with pancreatitis.
  
  
  
  Pancreatitis cases were categorized as gallstone-related acute pancreatitis (GSAP) (N = 1,065), non-GSAP (N = 1,222), and recurrent acute (RAP)/chronic pancreatitis (CP) (N = 523). We used the baseline questionnaire to identify alcohol intake and smoking history. Associations were estimated by hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox models.
  
  
  
  Cigarette smoking was associated with non-GSAP and RAP/CP. Moderate alcohol intake was inversely associated with all types of pancreatitis in women (HRs, 0.66 to 0.81 for <1 drink per day), and with RAP/CP in men (HR, 0.57; 95% CI, 0.41-0.79 for <2 drinks per day). The risk of non-GS pancreatitis associated with current smoking was highest among men who consumed more than 4 drinks per day (HR, 2.06; 95% CI, 1.28-3.30), whereas among never smokers, moderate drinking was associated with a reduced risk (HR, 0.70; 95% CI, 0.51-0.96). In women, drinking less than 2 drinks per day was associated with a reduced risk of GSAP among never smokers (HR, 0.61; 95% CI, 0.46-0.80).
  
  
  
  Smoking is a risk factor for non-GS pancreatitis. Moderate alcohol intake is protective against all types of pancreatitis in women and against RAP/CP in men.
authors.affiliation: From the *Department of Preventive Medicine, and †Norris Comprehensive Cancer Center, Keck School of Medicine of University of Southern California, Los Angeles, CA; ‡Division of Gastroenterology, Department of Medicine, Cedars-Sinai Medical Center and Department of Veterans Affairs, Los Angeles, CA; §Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI; ∥Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Veronica Wendy
authors.initials: VW
authors.lastname: Setiawan
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Pandol
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Porcel
authors.forename: Lynne R
authors.initials: LR
authors.lastname: Wilkens
authors.forename: Loïc
authors.initials: L
authors.lastname: Le Marchand
authors.forename: Malcolm C
authors.initials: MC
authors.lastname: Pike
authors.forename: Kristine R
authors.initials: KR
authors.lastname: Monroe
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology* / Q000208:ethnology; D001213:Asian / Q000706:statistics & numerical data; D002140:California / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000453:epidemiology* / Q000208:ethnology; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods / Q000706:statistics & numerical data*; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology* / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data