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P583. Attitudes to smoking in people with Crohn's disease

H. Sathanapally1, A. Wilson1, T. Moshkovska1, J. Mayberry1, 1University of Leicester, Leicester, United Kingdom

Background

Smoking is associated with a more aggressive disease course for people with Crohn's disease [1], and it has been suggested that the benefits of smoking cessation are of a similar magnitude to immunosuppressive therapy [2]. However, the prevalence of smoking amongst people with Crohn's in the UK is high, with the most recent reports of the prevalence of smoking amongst people with Crohn's across the UK being 30% [3] and 33% [4]. In order to facilitate the development of strategies to promote smoking cessation amongst people with Crohn's disease, this study aimed to explore the attitudes towards smoking and smoking cessation amongst people with Crohn's disease, as well as the barriers and facilitators to smoking cessation that people with Crohn's experience.

Methods

Semi-structured qualitative interviews were conducted with seventeen patients who had an established diagnosis of Crohn's disease, and were either current smokers or ex-smokers, recruited from Gastroenterology outpatient clinics at the Leicester General hospital. The interviews were transcribed verbatim and analysed using the Framework approach [5]. The qualitative findings were used to guide the development of a structured questionnaire for future use.

Results

In spite of being aware of the existence of an adverse link between smoking and Crohn's disease, many participants did not appreciate the importance of the impact of smoking on the course of Crohn's disease and the importance of smoking cessation for people with Crohn's disease. Whilst one factor that appeared to lead to this attitude was a lack of personal experience of an adverse link, participants also spoke about not having had enough information about the consequences of continuing to smoke. The use of smoking as a mechanism to cope with Crohn's disease emerged as amongst the factors involved in the participants' decision to smoke and the difficulties of quitting smoking while also coping with Crohn's disease emerged as amongst the barriers to smoking cessation.

Conclusion

The findings of this study suggest that people with Crohn's would benefit from being given more information regarding the impact of smoking on their disease and the benefits of smoking cessation. Additionally, the finding that factors related to Crohn's disease could be influencing the patients' decision to smoke, and could also be acting as barriers to quitting smoking, indicate that the development of smoking cessation interventions tailored towards Crohn's patients could be effective.

1. Cosnes J, Carbonnel F, Carrat F, Beaugerie L, Cattan S, Gendre J, (1999), Effects of current and former cigarette smoking on the clinical course of Crohn's disease

2. Johnson GJ, Cosnes J, Mansfield JC, (2005), Review article: smoking cessation as primary therapy to modify the course of Crohn's disease

3. UK IBD Audit Steering Group., (2010), UK IBD Audit round 3 – Report of the results for the national clinical audit of adult IBD inpatient care in the UK, http://www.rcplondon.ac.uk/sites/default/files/national-adult-uk-ibd-inpatient-care-audit-report-round-3.pdf

4. Bardhan KD, Simmonds N, Royston C, Dhar A, Edwards CM, (2010), A United Kingdom inflammatory bowel disease database: Making the effort worthwhile.

5. Ritchie J, Spencer L, (1994), Qualitative data analysis for applied policy research. In: Bryman A, Burgess R, editors. Analyzing qualitative data, 173–194.