Imperial College London
Alternate

PROFESSOR AZEEM MAJEED

Faculty of Medicine, School of Public Health

Chair - Primary Care and Public Health & Head of Department
 
 
 
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Contact

 

+44 (0)20 7594 3368a.majeed Website

 
 
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Assistant

 

Ms Dorothea Cockerell +44 (0)20 7594 3368

 
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Location

 

Reynolds BuildingCharing Cross Campus

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Summary

 

Publications

Citation

BibTex format

@article{Saxena:2018:10.1038/s41395-018-0273-7,
author = {Saxena, S and Alexakis, C and Chhaya, V and Cecil, E and Majeed, A and Pollok, R},
doi = {10.1038/s41395-018-0273-7},
journal = {The American Journal of Gastroenterology},
pages = {1689--1700},
title = {Smoking status at diagnosis and subsequent smoking cessation: associations with cortic os use and intestinal resection in  Crohn's disease},
url = {http://dx.doi.org/10.1038/s41395-018-0273-7},
volume = {113},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - BackgroundThe impact of smoking at diagnosis and subsequent smoking cessation on clinical outcomes in Crohn’s disease (CD) has not been evaluated in a population-based cohort.MethodsUsing a nationally representative clinical research database, we identified incident cases of CD between 2005 and 2014. We compared the following outcomes: overall corticosteroid (CS) use; flares requiring CS; CS dependency and intestinal surgery between smokers and non-smokers at time of CD diagnosis. Differences in these outcomes were also compared between persistent smokers and smokers who quit within 2 years of diagnosis.ResultsWe identified 3553 patients with a new CD diagnosis over the study period of whom 1121 (32%) were smokers. Smokers at CD diagnosis had significantly higher CS-use (56 versus 47%, p < 0.0001), proportionally more CS flares (>1 CS flare/year: 9 versus 6%, p < 0.0001), and higher CS dependency (27 versus 21%, p < 0.0001) than non-smokers. Regression analysis identified smoking at diagnosis to be associated with a higher risk of intestinal surgery (HR 1.64, 95% CI 1.16–2.52). There was a significantly higher proportion of ‘quitters’ who remained steroid-free through follow-up in comparison to ‘persistent smokers’ (45.4 versus 37.5%, respectively, p = 0.02). ‘Quitters’ also had lower rates of CS dependency compared to ‘persistent smokers’ (24 versus 33%, p = 0.008).ConclusionsSmokers at CD diagnosis have higher CS-use, CS dependency and higher risk of intestinal surgery. Quitting smoking appears to have beneficial effects on disease related outcomes, including reducing CS dependency highlighting the importance of offering early smoking cessation support.
AU  - Saxena,S
AU  - Alexakis,C
AU  - Chhaya,V
AU  - Cecil,E
AU  - Majeed,A
AU  - Pollok,R
DO  - 10.1038/s41395-018-0273-7
EP  - 1700
PY  - 2018///
SN  - 1572-0241
SP  - 1689
TI  - Smoking status at diagnosis and subsequent smoking cessation: associations with cortic os use and intestinal resection in  Crohn's disease
T2  - The American Journal of Gastroenterology
UR  - http://dx.doi.org/10.1038/s41395-018-0273-7
UR  - http://hdl.handle.net/10044/1/63433
VL  - 113
ER  -
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