Search in the Abstract Database

Search Abstracts 2011

* = Presenting author

P285. Smoking pattern of our Crohn's patients: Our intervention and outcome

M.H. Thoufeeq, Z.M. Al-Ani, S. Win, J. Bettany

Diana Princess of Wales Hospital, Grimsby, United Kingdom

Introduction: The disease process of Crohn's disease has been found to be influenced by smoking.

Lakatos et al found the percentage of current smokers to be significantly higher among Crohn's patients than in a control population in Hungary. Studies have shown that the need for steroids and immunosuppressants to be higher among smokers than non-smokers.

It is important to understand the smoking pattern among patients with Crohn's disease as this would help us in counselling patients against smoking.

Aims: The principal aim was to identify the smoking pattern among our Crohn's patients. We wanted to know if ileal involvement was more common among smokers. Besides this, we wanted to know if patients stopped smoking on our advice.

Methods: This study was done at a district general hospital setting in the United Kingdom.

We enquired patients about their smoking history during their outpatient clinic or endoscopic appointments. We retrieved further information from clinical notes, endoscopy reports and electronic radiology records.

We documented their smoking history in their medical notes and adviced patients about the risks of smoking in CD. Small bowel disease was considered positive if found on ileo-colonoscopy, surgery or radiological imaging.

All Crohn's patients were adviced to stop smoking and non-smokers were adviced to maintain their non-smoking habits. For those who were smokers at the time of collection of data, we enquired about their smoking pattern after 1 year to see if they have changed their smoking pattern. We wanted to know how many had stopped, cut down or made no change.

Results: There were a total of 145 Crohn's patients included. The ranges of age were between 16 and 86 years. Mean age of diagnosis was 33 years. The sex ratio is almost equal. 50% of CD patients had small bowel disease. Overall, 67% of CD patients with ileal involvement were either currently smoking or ex-smokers.

34 patients (23%) were smoking at start of the study. Among those who were adviced, we were able to get information from 28 patients about their smoking pattern in the following year. 6 of these 28 patients (21%) had stopped smoking. 83% of these were males. Their mean duration of disease was 27.5 years. Five (83%) of these patients had small bowel disease. Their mean age included 57 years. 18 of the 28 (64%) patients made no change to their smoking pattern and continued to smoke, 44% of these were males, and their mean duration of disease was 17.3 years. 66% of these had small bowel disease. A further 4 of 28 (14%) reduced the number cigarettes they smoked on advice.

Conclusion: A quarter of CD patients smoke. Majority of patients with ileal involvement in Crohn's disease had a positive smoking history. The majority of patients who stopped smoking on advice were males, those with longer duration of disease and with small bowel disease.