Smoking cessation and the course of Crohn's disease: An intervention study

Background & Aims: To evaluate the benefit of smoking cessation in individu als with Crohn's disease, we performed an intervention study in a large coh ort of smokers with the disease. Methods: Repeated counseling to stop smoki ng, with easy access to a smoking cessation program, was given to 474 conse cutive smokers with Crohn's disease. Patients who stopped smoking for more than 1 year (quitters) were included in a prospective follow-up study, whic h compared disease course and therapeutic needs with 2 control groups, cont inuing smokers and nonsmokers, paired for age, gender, disease location, an d activity. Results: There were 59 quitters (12%). Predictors of quitting w ere the physician, previous intestinal surgery, high socioeconomic status, and in women, oral contraceptive use. During a median follow-up of 29 month s (1-54 months), the risk of flare-up in quitters did not differ from that in nonsmokers and was less than in continuing smokers (P < 0,001). Need for steroids and for introduction or reinforcement of immunosuppressive therap y, respectively, were similar in quitters and nonsmokers and increased in c ontinuing smokers. The risk of surgery was not significantly different in t he 3 groups. Conclusions: Patients with Crohn's disease who stop smoking fo r more than 1 year have a more benign disease course than if they had never smoked.