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Journal of Crohn's and Colitis: 9 (7)

Editor-in-Chief

Laurence J. Egan, Ireland

Associate Editors

Maria T. Abreu, USAShomron Ben-Horin, IsraelSilvio Danese, ItalyPeter Lakatos, HungaryMiles Parkes, UKGijs van den Brink, NLSéverine Vermeire, Belgium

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High smoking cessation rate in Crohn's disease patients after physician advice – The TABACROHN Study

Tiago Nunes , Maria Josefina Etchevers , Olga Merino , Sonia Gallego , Valle García-Sánchez , Ignacio Marín-Jiménez , Luis Menchén , Manuel Barreiro-de Acosta , Guillermo Bastida , Sara García , Elena Gento , Daniel Ginard , Eva Martí , Fernando Gomollón , Maite Arroyo , David Monfort , Esther García-Planella , Benito Gonzalez , Carme Loras , Carles Agustí , Carolina Figueroa , Miquel Sans ,
DOI: http://dx.doi.org/10.1016/j.crohns.2012.04.011 202-207 First published online: 1 April 2013

Abstract

Introduction: Tobacco smoking has a significant impact on the development of Crohn's disease (CD) and its clinical course, making smoking cessation one of the main goals in CD therapeutic strategy.

Aims: To evaluate the effectiveness of an advice-based smoking cessation strategy among CD patients.

Methods: We have performed a prospective multicenter study which enrolled 408 CD smokers. At inclusion all patients were instructed about the risks of smoking and subsequently followed every 3 months. Each center used additional smoking cessation strategies based on available resources. Urinary cotinine and exhaled carbon monoxide levels were evaluated in a subgroup of patients.

Results: Median study follow up was 18 months. 31% of the patients achieved complete smoking cessation and 23% were smoking-free at the end of their follow up with 8% of smoking relapse. Most patients not achieving smoking cessation did not change their smoking habit with only 5% presenting a decrease in tobacco load. 63% of patients willing to quit smoking received help from another specialist, most frequently the pulmonologist (47%). Surprisingly, most patients (88%) tried to quit smoking with no pharmacological therapy and bupropion, varenicline and nicotine replacement treatment were used in few patients. Urinary cotinine and exhaled CO levels tested in a subgroup of patients proved to have a good correlation with the self-reported smoking habit. No predictors of successful smoking cessation were identified.

Conclusion: Our results underline that an anti-tobacco strategy mostly based on CD patients´s education and counseling is feasible and effective in helping patients reach complete abstinence.

Keyword
  • Inflammatory bowel disease
  • Crohn's disease
  • Environmental factors
  • Smoking
  • Tobacco
  • Smoking cessation
  • Abbreviations
    CD
    Crohn's disease
    UC
    Ulcerative colitis
    IBD
    Inflammatory bowel disease
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