Crohn’s disease rates highest in states with high smoking rates: Study
Published 21 Jun 2016
According to a research study conducted at the Price Institute of Surgical Research, in Louisville, Kentucky, and published in the Journal of Clinical Gastroenterology, U.S. states that report the highest rates of Crohn’s disease (CD) also have high smoking rates.
For the study, the researchers incorporated a linear regression analysis of national data. After analyzing all the relevant data, the researchers concluded that there is a correlation between regionally high rates of smoking and the number of Crohn’s disease hospital discharges for that region. Before the study, the investigators had a theory, which was based on an established fact that compared to non-smoking CD patients, smoker CD patients have a 2.5-fold increased risk of surgical recurrence and twice the probability of disease relapse. The study proved that their theory was well founded.
U.S. states with high hospital discharges for Crohn’s disease: For the first part of the study, the researchers designed a population-based study and analyzed the Healthcare Cost and Utilization Project (HCUP) in order to have access to the discharge data on Crohn’s disease, ulcerative colitis, and lung cancer. The HCUP collects and stores patient discharge information from 30 U.S. states.
U.S. states with high smoker rates: For the next part of the study — finding the estimated smoking prevalence rates among adult residents in the same 30 states— the researchers analyzed data from the U.S. Centers for Disease Control and Prevention. West Virginia, Tennessee, Oklahoma, Kentucky, and Missouri are the states with the highest smoking rates, in which almost 25 percent of the adult population smokes. On the other hand New Jersey, Maryland, Utah, California, and Arizona, had the lowest percentage of smokers.
Correlation between high smoker U.S. states and high Crohn’s disease U.S. states: The results showed that while there was no indication of a relation between smoking and hospital discharges for ulcerative colitis, there was a definite correlation between smoking and hospital discharges for Crohn’s disease.
The effects of smoking on Crohn’s disease
Crohn’s disease patients who smoke may experience flare-up of symptoms like abdominal pain and diarrhea more frequently, than patients who do not smoke. They also face a higher risk of repeat surgeries and need more medication for their condition, than their nonsmoking counterparts. While researchers are not exactly sure how smoking in Crohn’s aggravates the symptoms of the disease, they suspect that cigarette smoke damages protective mucous membranes in the digestive system, thereby increasing the risk for inflammation.
There are some studies out of England that suggest that smoking can worsen Crohn’s and other inflammatory bowel diseases by restricting blood flow. They believe that by blocking blood flow, one is also blocking the action of substances that have the potential to reduce inflammation. Also, there is enough evidence to support the fact that smoking can make many medications less effective. Which could be the reason why certain anti-inflammatory drugs lose their potency in smokers with Crohn’s.
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