P595. Smoking in patients with IBD: increasing smoking rates and alarmingly low use of supportive measures to achieve smoking cessation - Data from the Swiss IBD cohort study
Smoking is one of the most extensively investigated environmental factors in IBD, with a well-known divergent effect on course of disease in UC and CD. However, there are only limited data on factors associated with smoking in patients with IBD including age- and sex-matched comparisons to the general population. Even less is known about the magnitude of supportive measures provided to smoking IBD patients to achieve cessation. Especially in UC, some physicians might be reluctant to use supportive measures, due to the misconception, that no overall health benefit would be obtained from smoking cessation in UC. We aimed to address these questions using prospectively obtained data from patients of the Swiss IBD Cohort Study (SIBDCS).
Data from patients participating in the SIBDCS were analysed and compared to the general Swiss population (GSP) matched by age, year and sex.
Among a total of 1770 IBD patients analysed (49.1% male), 29% are current smokers. More than twice as many patients with CD are active smokers compared to UC (39.6% vs. 15.3%, p < 0.001). The overall smoking rate in IBD patients is not different to the GSP. However, surprisingly and in contrast to the GSP, significantly more women than men with CD smoke (42.8% vs. 35.8%, p = 0.025; in contrast to 13.2% vs. 17% active smokers with UC in women and men, respectively, difference not significant). In addition, while smoking rates in men with CD are not different to the GSP, women with CD smoke significantly more often than the GSP throughout all age groups. Indeed, the highest smoking rate observed at all was 51.7% in women with CD aged 45–54 years, which is virtually twice as high as in the matched GSP (26.6%, p < 0.001). In contrast the smoking rates in UC are significantly lower than in the GSP throughout all age groups. In the GSP a clear trend of decreasing smoking rates has been observed within the last years. In striking contrast an increasing trend can be found in the overall swiss IBD patiens (p = 0.003). Importantly, this increasing trend is significant for women with IBD in general and CD in particular, while no such trend was observed in men.
Only 13% of smoking IBD patients received any support to cease smoking. This number is significantly lower in UC compared to CD patients (2.3% vs. 13.8%, p = 0.001; no differences according to sex, age-groups, level of education and country of origin).
Despite the well-established detrimental effects, smoking rates in CD are alarmingly high, especially in women. In contradiction to the general Swiss population we found a significant trend for increasing smoking rates in recent years in our cohort. There is an unacceptable underuse of supportive measures to achieve smoking cessation, especially in UC.