The researchers evaluated the benefit of smoking cessation in individuals with Crohn's disease and reported their findings in April's Gastroenterology.
|Steroid treatment and immunosuppressive therapy were increased in continuing smokers.
The intervention study enrolled 474 consecutive smokers with Crohn's disease. Each individual was provided with repeated counseling to stop smoking, with easy access to a smoking cessation program.
Patients who stopped smoking for more than 1 year ('quitters') were included in a prospective follow-up study. This compared disease course and therapeutic needs with two control groups: (1) continuing smokers and (2) non-smokers. They were paired for age, gender, disease location, and activity.
The group found that there were 59 quitters (12%). Predictors of quitting were the physician, previous intestinal surgery, high socioeconomic status, and, in women, oral contraceptive use.
During a median follow-up of 29 months, the risk of flare-up in quitters did not differ from that in non-smokers, and was less than in continuing smokers.
Need for steroids and for introduction or reinforcement of immunosuppressive therapy, respectively, were similar in quitters and non-smokers, and increased in continuing smokers.
The risk of surgery was not significantly different in the three groups.
Jacques Cosnes, of the Rothschild Hospital, Paris, concluded, "Patients with Crohn's disease who stop smoking for more than 1 year have a more benign disease course than if they had never smoked."