P572. Changes of the smoking habit after diagnosis of Crohn's disease
R. de Francisco1, S. Riestra1, I. Perez1, L. Blanco1, O. Castano1, M. Varela1, L. Rodrigo1, 1Huca, Gastroenterology, Oviedo, Spain
Tobacco has a negative impact on Crohn's disease (CD). Smoking cessation is a key part in the management of CD. The aims of this study were to determine the smoking status of CD patients both at diagnosis and at present, and to assess the level of awareness about the harmful effects of tobacco on the evolution of the disease.
CD patients attended at an IBD Unit between September 2011 and October 2012 were invited to complete a questionnaire on their smoking habits. Current smokers were asked if they had previously tried to quit, why they thought they were not achieved it, and if they would be willing to participate in a smoking cessation program. We also investigated, in ex-smokers, which methods were used to quit smoking and their perception of the effect of the abandonment of tobacco in the evolution of the CD.
467 patients were included in the study (46.5% male, a mean age at diagnosis of 31.9 years and a mean duration of CD of 10.1 years). At diagnosis, 239 patients (51.1%) were smokers, 184 (39.4%) non-smokers and 44 (9.4%) ex-smokers. At present, 112 out 239 smokers (46.8%) had quit the smoking, 54 of them for reasons related to the CD and 58 for other reasons. Most ex-smokers did not need smoking cessation therapy and only 7 have assisted to specialized units in smoking cessation. 79 (70.5%) patients knew that the tobacco was harmful to their disease. 70 (62.5%) noted improvement in their health, but only 21 (18.7%) in symptoms related to CD.
Regarding 127 (53.2%) patients who continued smoking, 94 (74.0%) reported having been informed by the physician of the negative impact of smoking on their disease. 93 (73.2%) had attempted to quit smoking, and anxiety was the most common reason (35%) of failure to quit. 95 (74.2%) patients wanted to quit smoking now, but only 48 (37.7%) were willing to participate in a smoking cessation program.
In total, 138 out 467 patients (29.5%) are active smokers (127 patients were smokers since before diagnosis, 10 patients started smoking after diagnosis and 1 ex-smoker relapsed after diagnosis).
In our area, about 50% of CD patients that were smokers at diagnosis have quit smoking. In patients who continue to smoke, medical counseling is not sufficient, and other therapeutic measures are required.