High smoking cessation rate in Crohn's disease patients after physician advice - The TABACROHN Study

被引:43
作者
Nunes, Tiago [1 ]
Josefina Etchevers, Maria [1 ]
Merino, Olga [2 ]
Gallego, Sonia [3 ]
Garcia-Sanchez, Valle [4 ]
Marin-Jimenez, Ignacio [5 ]
Menchen, Luis [5 ]
Barreiro-de Acosta, Manuel [6 ]
Bastida, Guillermo [7 ]
Garcia, Sara [8 ]
Gento, Elena [8 ]
Ginard, Daniel [9 ]
Marti, Eva [9 ]
Gomollon, Fernando [10 ]
Arroyo, Maite [10 ]
Monfort, David [11 ]
Garcia-Planella, Esther [12 ]
Gonzalez, Benito [13 ]
Loras, Carme [14 ]
Agusti, Cartes [1 ]
Figueroa, Carolina [1 ]
Sans, Miguel [1 ]
机构
[1] Hosp Clin Barcelona, IDIBAPS, Barcelona, Spain
[2] Hosp Cruces, Baracaldo, Spain
[3] Hosp Miguel Servet, Zaragoza, Spain
[4] Hosp Reina Sofia, Cordoba, Spain
[5] Hosp Gen Gregorio Maranon, Madrid, Spain
[6] Hosp Clin Univ, Santiago De Compostela, Spain
[7] Hosp La Fe, E-46009 Valencia, Spain
[8] Hosp Gen Vague, Burgos, Spain
[9] Hosp Univ Son Espases, Palma De Mallorca, Spain
[10] Hosp Clin, Zaragoza, Spain
[11] Consorci Sanitari Terrassa, Terrassa, Spain
[12] Hosp Santa Creu & Sant Pau, Barcelona, Spain
[13] Hosp Juan Canalejo, La Coruna, Spain
[14] Hosp Mutua Terrassa, Terrassa, Spain
关键词
Inflammatory bowel disease; Crohn's disease; Environmental factors; Smoking; Tobacco; Smoking cessation; INFLAMMATORY-BOWEL-DISEASE; CIGARETTE-SMOKING; RECURRENCE; TOBACCO; METAANALYSIS; BEHAVIORS; RISK;
D O I
10.1016/j.crohns.2012.04.011
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Introduction: Tobacco smoking has a significant impact on the development of Crohn's disease (CD) and its clinical course, making smoking cessation one of the main goals in CD therapeutic strategy. Aims: To evaluate the effectiveness of an advice-based smoking cessation strategy among CD patients. Methods: We have performed a prospective multicenter study which enrolled 408 CD smokers. At inclusion all patients were instructed about the risks of smoking and subsequently followed every 3 months. Each center used additional smoking cessation strategies based on available resources. Urinary cotinine and exhaled carbon monoxide levels were evaluated in a subgroup of patients. Results: Median study follow up was 18 months. 31% of the patients achieved complete smoking cessation and 23% were smoking-free at the end of their follow up with 8% of smoking relapse. Most patients not achieving smoking cessation did not change their smoking habit with only 5% presenting a decrease in tobacco load. 63% of patients willing to quit smoking received help from another specialist, most frequently the pulmonologist (47%). Surprisingly, most patients (88%) tried to quit smoking with no pharmacological therapy and bupropion, varenicline and nicotine replacement treatment were used in few patients. Urinary cotinine and exhaled CO levels tested in a subgroup of patients proved to have a good correlation with the self-reported smoking habit. No predictors of successful smoking cessation were identified. Conclusion: Our results underline that an anti-tobacco strategy mostly based on CD patients's education and counseling is feasible and effective in helping patients reach complete abstinence. (C) 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:202 / 207
页数:6
相关论文
共 33 条
[1]  
ANDA RF, 1987, JAMA-J AM MED ASSOC, V257, P1916
[2]   Effect of cigarette smoking on the course of Crohn's disease [J].
BreuerKatschinski, BD ;
Hollander, N ;
Goebell, H .
EUROPEAN JOURNAL OF GASTROENTEROLOGY & HEPATOLOGY, 1996, 8 (03) :225-228
[3]   A META-ANALYSIS OF THE ROLE OF SMOKING IN INFLAMMATORY BOWEL-DISEASE [J].
CALKINS, BM .
DIGESTIVE DISEASES AND SCIENCES, 1989, 34 (12) :1841-1854
[4]  
Cosnes J, 1999, ALIMENT PHARM THERAP, V13, P1403
[5]   Tobacco and IBD: relevance in the understanding of disease mechanisms and clinical practice [J].
Cosnes, J .
BEST PRACTICE & RESEARCH CLINICAL GASTROENTEROLOGY, 2004, 18 (03) :481-496
[6]   Effects of cigarette smoking on the long-term course of Crohn's disease [J].
Cosnes, J ;
Carbonnel, F ;
Beaugerie, L ;
LeQuintrec, Y ;
Gendre, JP .
GASTROENTEROLOGY, 1996, 110 (02) :424-431
[7]   Smoking cessation and the course of Crohn's disease: An intervention study [J].
Cosnes, J ;
Beaugerie, L ;
Carbonnel, F ;
Gendre, JP .
GASTROENTEROLOGY, 2001, 120 (05) :1093-1099
[8]   What Is the Link Between the Use of Tobacco and IBD? [J].
Cosnes, Jacques .
INFLAMMATORY BOWEL DISEASES, 2008, 14 :S14-S15
[9]   SMOKING-HABITS AND RECURRENCE IN CROHNS-DISEASE [J].
COTTONE, M ;
ROSSELLI, M ;
ORLANDO, A ;
OLIVA, L ;
PULEO, A ;
CAPPELLO, M ;
TRAINA, M ;
TONELLI, F ;
PAGLIARO, L .
GASTROENTEROLOGY, 1994, 106 (03) :643-648
[10]  
Etchevers Maria J, 2009, Gastroenterol Hepatol, V32 Suppl 2, P37, DOI 10.1016/S0210-5705(09)72604-4