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P740 What kind of IBD patients succeed in smoking cessation? Insights from the Swiss IBD cohort study

Grueber M.*1, Allez M.2, Biedermann L.3, Clair Willi C.4, Fournier N.5, Schöpfer A.6, Vavricka S.7, Juillerat P.8, Macpherson A.J.9

1Inselspital, Bern, Department of Gastroenterology, Bern, Switzerland 2Hôpital Saint-Louis, Gastroenterology, Lausanne, France 3Universitätsspital, Gastroenterology, Zürich, Switzerland 4CHUV, PMU, Lausanne, Switzerland 5CHUV, Statistics, Lausanne, Switzerland 6CHUV, Gastroenterology, Lausanne, Switzerland 7Stadtspital Triemli, Gastroenterology, Zürich, Switzerland 8Inselspital, Gastroenterology, Bern, Switzerland 9Inselpital, Gastroenterology, Bern, Switzerland

Background

Tobacco consumption is known to have a differential effect in Crohn's disease (CD) and Ulcerative colitis (UC). Smoking cessation can transiently worsen disease course in UC whereas it should be beneficial to CD patients. Our aim was to identify whether this effect drives success in smoking cessation.

Methods

Retrospective analysis of prospectively yearly collected data from adult UC and CD patients included in the Swiss IBD cohort study (SIBDCS) from November 2006 to November 2015.

Results

999 UC and 1368 CD patients were included in the study and separated in three groups (smokers, past-smokers and non-smokers at enrollment). In general, past smokers who succeed in smoking cessation are males, older, with a higher BMI (p<0.001). The disease location was less extensive in UC (mostly left sided colitis and proctitis) (p=0.121) and less ileal in CD (compared to active CD smokers) (p=0.009). Concerning treatment, UC past smokers used significantly more topical treatment and CD past smokers required less anti-TNF and conventional immunosuppressants. The disease severity measured by clinical scores and CRP/albumin showed no significant difference.

Conclusion

UC and CD patients in the Swiss IBD cohort who succeed in smoking cessation seem to be patients with a pattern of disease which is less likely to be influenced by smoking. Further investigations are needed to identify whether this phenotype is due to smoking cessation or likely to ease it.