Skip to main content
SpringerLink
Log in

A meta-analysis of the role of smoking in inflammatory bowel disease

  • Original Articles
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

A relationship between not smoking and ulcerative colitis has been examined in all English reports. This paper evaluates the ulcerative colitis/nonsmoking and the Crohn's disease/smoking association by meta-analysis and against causality criterion for chronic diseases. A review of the literature, meta-analysis of selected studies, and assessment of causality criterion all suggest that not smoking and ulcerative colitis and smoking and Crohn's disease are consistent with a causal relationship. It is not inconceivable that tobacco may contain some substance beneficial to ulcerative colitis patients. Identification of the specific product in tobacco producing a beneficial effect would be a prudent next step in the study of this association. In spite of the findings of this review and analysis, the author finds no justification for health care providers to change the Surgeon General's recommendations on smoking or tobacco use for ulcerative colitis patients specifically.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Harries AD, Baird A, Rhodes J: Non-smoking: A feature of ulcerative colitis. Br Med J 284:706, 1982

    Google Scholar 

  2. Harries AD, Jones L, Heatley RV, Rhodes J: Smoking habits and inflammatory bowel disease: Effect on nutrition. Br Med J 284:1161, 1982

    Google Scholar 

  3. Bures J, Fixa B, Komarkova O, Fingerland A: Br Med J 285:440, 1982 (letter)

    Google Scholar 

  4. Gyde SN, Prior P, Taylor K, Allan RN: Cigarette smoking, blood pressure, and ulcerative colitis. Gut 24:A998, 1983

    Google Scholar 

  5. Jick H, Walker AM: Cigarette smoking and ulcerative colitis. N Engl J Med 308:261–263, 1983

    PubMed  Google Scholar 

  6. Hanauer SB, Silverstein MD, Evans AA, Kirsner JB: A case-control study of smoking in inflammatory bowel disease compared to the irritable bowel syndrome. Clin Res 32:233A, 1984

    Google Scholar 

  7. Benoni C, Nilsson A: Smoking habits in patients with inflammatory bowel disease. Scand J Gastroenterol 19:824–830, 1984

    PubMed  Google Scholar 

  8. Logan RFA, Edmond M, Somerville KW, Langman MJS: Smoking and ulcerative colitis. Br Med J 288:751–753, 1984

    Google Scholar 

  9. Calkins B, Lilienfeld A, Mendeloff A, Garland C, Monk M, Garland F: Smoking factors in ulcerative colitis and Crohn's disease in Baltimore. Am J Epidemiol 120:498, 1984

    Google Scholar 

  10. Holdstock G, Savage D, Harman M, Wright R: Should patients with inflammatory bowel disease smoke? Br Med J 288:362, 1984

    Google Scholar 

  11. Thornton JR, Emmett PM, Heaton KW: Smoking, sugar, and inflammatory bowel disease. Br Med J 290:1786–1787, 1985

    Google Scholar 

  12. Stermer E, Levy N, Heinrich I: Smoking, sugar, and inflammatory bowel disease. Br Med J 291:487, 1985

    Google Scholar 

  13. Porro GBN, Panza E: Smoking, sugar, and inflammatory bowel disease. Br Med J 291:971–972, 1985

    Google Scholar 

  14. Burns DG: Smoking in inflammatory bowel disease and the irritable bowel syndrome. S Afr Med J 69:232–233, 1986

    PubMed  Google Scholar 

  15. Vessey M, Jewel D, Smith A, Yeates D, McPherson K: Chronic inflammatory bowel disease, cigarette smoking, and use of oral contraceptives: Findings in a large cohort study of women of childbearing age. Br Med J 292:1101–1103, 1986

    Google Scholar 

  16. Tobin MV, Logan RFA, Langman MJS, McConnel RB, Gilmore IT: Cigarette smoking and inflammatory bowel disease. Gastroenterology 93:316–321, 1987

    PubMed  Google Scholar 

  17. Benoni C, Nilsson A: Smoking habits in patients with inflammatory bowel disease. Scand J Gastroenterol 22:1130–1136, 1987

    PubMed  Google Scholar 

  18. Franceschi S, Panza E, La Vecchia C, Parazzini F, DeCarli A, Porro GB: Nonspecific inflammatory bowel disease and smoking. Am J Epidemiol 125:445–452, 1987

    PubMed  Google Scholar 

  19. Boyko EJ, Koepsell TD, Perera DR, Inui TS: Risk of ulcerative colitis among former and current cigarette smokers. N Engl J Med 316:707–710, 1987

    PubMed  Google Scholar 

  20. Lindberg E, Tysk C, Andersson K, Järnerot G: Smoking and inflammatory bowel disease. A control study. Gut 29:352–357, 1988

    PubMed  Google Scholar 

  21. Mantel N, Haenszel W: Statistical aspects of the analysis of data from retrospective studies of disease. J Natl Cancer Inst 22:7119–7148, 1959

    Google Scholar 

  22. Robins J, Greenland S, Breslow NE: A general estimator for the variance of the Mantel-Haenszel odds ratio. Am J Epidemiol 124:719–723, 1986

    PubMed  Google Scholar 

  23. Fleiss J: Statistical Methods for Rates and Proportions. New York, John Wiley & Sons, 1981

    Google Scholar 

  24. Wald NJ, Nanchahal K, Thompson SG, Cuckle HS: Does breathing other people's tobacco smoke cause lung cancer? Br Med J 293:1217–1221, 1986

    Google Scholar 

  25. The health consequences of smoking: cancer. A report of the Surgeon General. US Department of Health and Human Services, Public Health Service, Office on Smoking and Health, Rockville, Maryland, 1982

  26. Calkins BM, Mendeloff AI: Epidemiology of inflammatory bowel disease. Epidemiol Rev 8:60–91, 1986

    PubMed  Google Scholar 

  27. Hoff G, Vatn MH, Larsen S: Relationship between tobacco smoking and colorectal polyps. Scand J Gastroenterol 22:13–16, 1987

    PubMed  Google Scholar 

  28. Yen S, Hsieh C, McMahon B: Extrahepatic bile duct cancer and smoking, beverage consumption, past medical history, and oral contraceptive use. Cancer 59:2112–2116, 1987

    PubMed  Google Scholar 

  29. Logan RFA, Kay CR: Oral Contraception, smoking and inflammatory bowel disease — findings in the Royal College of General Practicioners oral contraception study. Int J Epidemiol 18:105–107, 1989

    PubMed  Google Scholar 

  30. Calkins BM, Lilienfeld AM, Garland CF, Mendeloff AI: Trends in incidence rates of ulcerative colitis and Crohn's disease. Dig Dis Sci 29:913–920, 1984

    PubMed  Google Scholar 

  31. Somerville KW, Logan RFA, Edmond M, Langman MJS: Smoking and Crohn's disease. Br Med J 298:954–956, 1984

    Google Scholar 

  32. Cope GF, Heatley RV, Kelleher J: Smoking and colonic mucus in ulcerative colitis. Br Med J 293:481, 1986

    Google Scholar 

  33. MacDermott RP, Donaldson RM, Trier JS: Glycoprotein synthesis and secretion by mucosal biopsies of rabbit colon and human rectum. J Clin Invest 54:545–554, 1974

    PubMed  Google Scholar 

  34. Roberts CJ, Diggle R: Non-smoking: A feature of ulcerative colitis. Br Med J 285:440, 1982

    Google Scholar 

  35. deCastella J: Non-smoking: A feature of ulcerative colitis. Br Med J 284:1706, 1982 (letter)

    Google Scholar 

  36. Koop CE: Statement of C. Everett Koop, MD, ScD, Surgeon General Public Health Services, US Department of Health and Human Services before the Subcommittee on Health and the Environment, Committee on Energy and Commerce, US House of Representatives, July 29, 1988

Download references

Author information

Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Medicine, Case Western Reserve University, Cleveland, Ohio

    Beverly M. Calkins DHSc

Authors
  1. Beverly M. Calkins DHSc
    View author publications

    You can also search for this author in PubMed Google Scholar

Additional information

This work was partially supported by R01 DK38829-01 and R01 DK38693-01.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Calkins, B.M. A meta-analysis of the role of smoking in inflammatory bowel disease. Digest Dis Sci 34, 1841–1854 (1989). https://doi.org/10.1007/BF01536701

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01536701

Key words

Search

Navigation