THE ROLE OF CIGARETTES AND NICOTINE IN THE ONSET AND TREATMENT OF ULCERATIVE-COLITIS

Epidemiological evidence suggests that ulcerative colitis is a disease of nonsmokers, while Crohn's disease is a disease of smokers. The rel ative risk of developing ulcerative colitis is not only greater in non smokers, in addition there appears to be a rebound effect in smokers w ho quit, with the heaviest (ex-)smokers increasing their relative risk of the disease the most. This factor poses an ethical dilemma for hea lth professionals giving advice on stopping smoking, which may thus ha ve a serious detrimental effect on the health of some patients. Nicoti ne is believed to be the pharmacological ingredient of tobacco that is responsible for this beneficial effect and several clinical trials us ing nicotine have demonstrated it to be an effective therapeutic agent in the treatment of ulcerative colitis. Although the aetiology of ulc erative colitis is unclear, current research using nicotine-based prod ucts has produced some interesting clues, together with the possibilit y of some form of therapeutic treatment based on nicotine administrati on.