Background: While most studies have found a negative effect of smoking on Crohn's disease (CD) phenotype, more recent data have failed to reproduce this association, which might be due to a current wider use of thiopurines and biologic therapy. The TABACROHN study aimed at defining the impact of smoking on CD in the largest published series.
Methods: This multicenter cross-sectional study included 1170 CD patients. Patients were classified as nonsmokers, current smokers, or former smokers according to their present smoking status. Clinical data regarding disease characteristics, treatment, and complications were collected.
Results: Smokers were more frequently under maintenance treatment when compared to nonsmokers. In addition, current smokers presented higher use of biologic drugs compared to nonsmokers. Tobacco exposure and a higher tobacco load were independent predictors of need for maintenance treatment and stenosing phenotype, respectively.
Conclusions: In the era of early and widespread use of immunosuppressants and biologics, tobacco exposure is an independent predictor of need for maintenance treatment, specifically biologic therapy. The wider use of biologics and immunosuppressants could account for the existence of no major differences in disease behavior and complications between nonsmokers and current smokers.
Article first Published online 29 March 2012
1Hospital Clinic/IDIBAPS, Barcelona
2Hospital de Cruces, Barakaldo
3Hospital Miguel Servet, Zaragoza
4Hospital Reina Sofia, Córdoba
5Hospital Gregorio Marañón, Madrid
6Hospital Clinico Universitario, Santiago de Compostela
7Hospital La Fe, Valencia
8Hospital general Yague, Burgos
9Hospital Universitario Son Espases, Palma de Mallorca
10Hospital Clinico, Zaragoza
11Consorci Sanitari de Terrassa, Terrassa
12Hospital Sant Pau, Barcelona
13Hospital Juan Canalejo, A Coruña
14Hospital Mutua de Terrassa, Terrassa, Spain.
Reprints: Miquel Sans, MD, PhD, Department of Gastroenterology, Hospital Clínic i Provincial / IDIBAPS, 170 Villarroel, 08036 Barcelona, Spain (e-mail: firstname.lastname@example.org).
The first two authors contributed equally to this work.
† CIBEREHD: Centro de investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas.
Received February 24, 2012
Accepted February 28, 2012