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P074. Impact of smoking on Crohn's disease clinical course: Data from the multicenter Spanish study “TABACROHN”

T. Nunes1, M. Etchevers1, O. Merino2, S. Gallego3, V. García4, I. Marín5, L.A. Menchen5, M. Barreiro6, G. Bastida7, S. García8, E. Gento8, D. Ginard9, F. Gomollón10, M. Arroyo10, D. Monfort11, E. García12, B. Gonzalez13, C. Loras14, C. Agustí1, C. Figueroa1, M. Sans1

1Hospital Clinic/IDIBAPS, Barcelona, Spain; 2Hospital de Cruces, Barakaldo, Spain; 3Hospital Miguel Servet, Zaragoza, Spain; 4Hospital Reina Sofia, Córdoba, Spain; 5Hospital Gregorio Marañón, Madrid, Spain; 6Hospital Clinico Universitario, Santiago de Compostela, Spain; 7Hospital La Fe, Valencia, Spain; 8Hospital general Yague, Burgos, Spain; 9Hospital Son Dureta, Palma de Mallorca, Spain; 10Hospital Clinico, Zaragoza, Spain; 11Hospital de Terrassa, Terrassa, Spain; 12Hospital Sant Pau, Barcelona, Spain; 13Hospital Juan Canalejo, A Coruña, Spain; 14Hospital Mutua de Terrassa, Terrassa, Spain

Aim: Tobacco is associated with an increased risk of developing Crohn's disease (CD). TABACROHN is a long-term, prospective, ongoing study aimed at defining the impact of smoking habit on CD clinical course and investigating the usefulness of a tobacco cessation program. We present the influence of smoking habit on CD clinical course at patient inclusion in TABACROHN.

Material and Methods: Inactive CD patients defined by a Harvey-Bradshaw index ≤ 4 and a normal PCR were included. Patients were classified as active smokers (≥7 cigarettes per week), non-smokers (<7 cigarettes/week) or former smokers (quitted smoking at least 6 months before inclusion). Demographic and clinical data at inclusion was collected and analyzed.

Results: 1094 patients with CD were enrolled in TABACROHN, including 371 (33.9%) smokers, 463 (42.3%) non-smokers and 260 (23.8%) former smokers, with a median follow-up after CD diagnosis of 107 months. The age of onset was significantly higher in former smokers (44.3±13.8 years) than non-smokers (40.4±15.8 years, p = 0.001) and smokers (40.3±11.4 years, p = 0.001). Smokers presented more frequently ileocolonic location (41.5%) than non-smokers (32.8%) and former smokers (31.9%, p = 0.01). Non-smoking patients were more often without maintenance therapy (22.5%) than smokers (16.5%) or former smokers (17%, p = 0.03). Patients exposed to tobacco (either smokers or former smokers) presented more frequently stenosing or fistulizing CD phenotype than non-smokers (46.3% vs. 38.7%, p = 0.01). Exposed patients with more than 10 pack year of tobacco consumption presented less isolated inflammatory disease (49%) compared to patients with less than 10 pack year (63%, p < 0.05). Accordingly, estenosing disease was more frequently observed in patients with more than 10 pack year (28%) compared to light smokers (16%, p < 0.05). In addition, heavy smokers presented more often a positive history of previous CD-related surgery (47%) when compared to light smokers (30%, p < 0.05).

Conclusion: Smoking habit strongly influences CD clinical course.