Table 1.
Smoking in IBD: Practice points
| Ulcerative colitis (UC) | Crohn’s disease (CD) |
| Current smoking decreases the risk for UC by app. 50%, in contrast former smoking is associated with an app. 2-fold increased risk | Both current and former smoking (presumable also passive smoke exposure during childhood) increases the risk of CD almost 2-fold |
| The protective effect is smaller in females | The risk is greater in females compared with males |
| Proximal extension of the disease is less likely in smokers as well as disease course is milder but the risk of lung cancer and vascular disease is higher | Smoking is associated with complicated (stricturing or penetrating) and ileal disease |
| Patients who stop smoking experience an increase in disease activity at least during the first year after cessation | Smokers with CD need more steroids, more immunosuppressants and more operations than non-smokers |
| The effect of smoking is similar in indeterminate colitis (less evidence is available) | Smoking cessation improves rapidly the course of CD |
| Nicotine-replacement therapies and antidepressants are useful in heavy smokers motivated to stop smoking Geographic differences exists (e.g. Israel, Korea) | |