(04-10-12) Editorial: the truth about cigarette smoking and the risk of inflammatory bowel disease.

Rosenfeld G, Bressler B.
Source
Department of Medicine, Division of Gastroenterology, University of British
Columbia, Vancouver, British Columbia, Canada.
Abstract
The etiology of inflammatory bowel disease (IBD) is generally believed to be
multifactorial in nature involving both genetic and environmental factors.
Cigarette smoking has been shown through previous retrospective observational
studies to be an environmental factor with both positive and negative
influences in IBD. Smoking increases the risk of developing Crohn's disease
(CD) but not the risk of ulcerative colitis (UC). Meanwhile smoking cessation
increases the risk of a UC flare while CD patients are more likely to show a
decrease in disease severity. Unfortunately, these observational studies cannot
control for bias the way a randomized controlled trial can, however, they still
reveal meaningful truths about smoking and IBD. The study by Higuchi et al. (1)
adds to our understanding of the impact of smoking on IBD in several ways. They
showed that increasing exposure to smoking is associated with an increased risk
of developing CD. They also showed that the risk of UC is highest in the first
2-5 years after smoking cessation but remains elevated for >20 years. This
research also raises several new issues regarding the association between
smoking and IBD, which hopefully will be answered through future well-designed
observational studies.

Source: Am J Gastroenterol. 2012 Sep;107(9):1407-8. doi: 10.1038/ajg.2012.190.

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