Ulcerative Colitis Outcomes Similar for Smokers, Nonsmokers

Smokers and nonsmokers with ulcerative colitis (UC) have similar outcomes, according to a study published online in Alimentary Pharmacology and Therapeutics.

Jonathan Blackwell, B.M.B.S., from St. George's University in London, and colleagues examined the impact of smoking status and smoking cessation on disease outcomes. Incident cases of UC were identified during 2005 to 2016; patients were classified as never-smokers, ex-smokers, and smokers based on smoking status recorded in the two years prior to diagnosis.

A total of 6,754 patients with a new diagnosis of UC were identified, of whom 878 were smokers at diagnosis. The researchers found that compared with never-smokers, smokers had similar risks of corticosteroid-requiring flares (odds ratio, 1.16; 95 percent confidence interval [CI], 0.92 to 1.25), thiopurine use (hazard ratio [HR], 0.84; 95 percent CI, 0.62 to 1.14), corticosteroid dependency (HR, 0.85; 95 percent CI, 0.60 to 1.11), hospitalization (HR, 0.92; 95 percent CI, 0.72 to 1.18), and colectomy (HR, 0.78; 95 percent CI, 0.50 to 1.21). Persistent smokers and those who quit after diagnosis had no significant difference in the rates of flares, thiopurine use, corticosteroid dependency, hospitalization, and colectomy.

"Our findings should therefore embolden clinicians to advise against smoking and reassure patients who already smoke that they can benefit from the many advantages of smoking cessation without risk of worsening their UC," the authors write.

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