Helping patients with Crohn's disease quit smoking

Smoking is not only a risk factor for Crohn's disease, but ongoing smoking is associated with a poorer disease course. Therefore, smoking cessation sh ould be an important treatment strategy for Crohn's disease patients who sm oke tobacco. Recent improvements in understanding how people quit smoking a nd the development of pharmacological interventions, such as nicotine patch es and bupropion, have improved cessation rates. In this article, we first briefly review the evidence supporting the adverse effects of smoking on th e disease course. We next review the current understanding of how people ch ange addictive behaviors, such as smoking. We then describe how the gastroe nterologist can aid the patient with Crohn's disease to quit smoking, inclu ding appropriate and brief counseling strategies and the use of adjunctive treatments. Given the improvements in smoking cessation strategies, all pat ients with Crohn's disease should be strongly advised to quit smoking and b e aided in doing so. (C) 2000 by Am. Cell. of Gastroenterology.