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Effect of oral tobacco use and smoking on outcomes of Crohn's disease in India
Author(s) -
Arora Umang,
Ananthakrishnan Ashwin N,
Kedia Saurabh,
Bopanna Sawan,
Mouli Pratap Venigalla,
Yadav Dawesh P,
Makharia Govind K,
Yajnik Vijay,
Ahuja Vineet
Publication year - 2018
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13815
Subject(s) - medicine , odds ratio , disease , crohn's disease , retrospective cohort study , adverse effect , logistic regression , medical record , tobacco use , epidemiology , surgery , environmental health , population
Background and Aim Smoking has been linked with adverse outcomes in Crohn's disease (CD); however, it is not known whether oral tobacco (OT) use affects disease outcomes in these patients. The study aimed to assess the association between smoking or OT and outcomes in CD. Methods Retrospective analysis was performed on prospectively maintained records of CD patients from 2004 to 2016. The parameters assessed included disease characteristics at baseline (location, behavior, age at onset, perianal disease, and extraintestinal manifestations), course pattern, and outcomes (surgery, hospitalizations, immunomodulator or biologics use, and steroid requirement). Results A total of 426 patients were included (mean age: 39.9 years; 59.9% men; median follow up: 71 months). Forty patients were ever‐OT users, and 59 were ever‐smokers, ever‐use being defined as daily use for at least 2 years. OT use was associated with male sex and smoking. Both OT use and smoking had no effect on baseline characteristics, but upper gastrointestinal disease was less common in ever‐smokers. Both OT use and smoking did not have any effect on surgery, immunomodulator, and biologic use. Similarly, no association was found between these outcomes and duration, daily, and cumulative exposure to tobacco. Current but not former tobacco use in both smoked (adjusted odds ratio = 2.59 [1.22–5.49]) and OT (adjusted odds ratio = 2.97 [1.03–8.6]) forms increased risk of hospitalizations. Conclusion Oral tobacco use and smoking had no significant detrimental effect on disease phenotype or medical and surgical requirements in CD in Indian patients, affirming other non‐Caucasian studies that found lack of effect of smoking. However, current tobacco use in any form was associated with hospitalization during follow up.