Table 5. Pack-years of Smoking and Risk of Major GI Bleeding.
| Pack-years of Smoking | ||||||
|---|---|---|---|---|---|---|
| 0 | < 10 | 10–24 | 25–44 | ≥45 | P value for linear trenda | |
| Person-years | 421538 | 90534 | 165941 | 112604 | 58570 | |
| All GI bleedingb | ||||||
| No. of cases | 123 | 28 | 59 | 53 | 21 | |
| Age-adjusted HR (95% CI)c | 1.0 | 1.06 (0.70, 1.60) | 1.15 (0.85, 1.58) | 1.52 (1.10, 2.10) | 1.20 (0.75, 1.91) | 0.33 |
| Multivariable 1 HR (95% CI)d | 1.0 | 1.02 (0.68, 1.55) | 1.09 (0.79, 1.49) | 1.38 (0.99, 1.92) | 1.06 (0.66, 1.70) | 0.46 |
| Multivariable 2 HR (95% CI)e | 1.0 | 1.02 (0.67, 1.54) | 1.06 (0.77, 1.45) | 1.30 (0.93, 1.81) | 1.03 (0.64, 1.65) | 0.34 |
| Upper GI bleedingf | ||||||
| No. of cases | 62 | 8 | 26 | 26 | 11 | |
| Age-adjusted HR (95% CI)c | 1.0 | 0.60 (0.29, 1.25) | 1.01 (0.64, 1.61) | 1.48 (0.94, 2.35) | 1.24 (0.65, 2.37) | 0.24 |
| Multivariable 1 HR (95% CI)d | 1.0 | 0.56 (0.27, 1.18) | 0.95 (0.60, 1.52) | 1.34 (0.83, 2.14) | 1.05 (0.54, 2.02) | 0.33 |
| Multivariable 2 HR (95% CI)e | 1.0 | 0.56 (0.27, 1.18) | 0.94 (0.59, 1.50) | 1.27 (0.79, 2.04) | 0.99 (0.51, 1.91) | 0.42 |
| Lower GI bleedingf | ||||||
| No. of cases | 46 | 18 | 26 | 18 | 7 | |
| Age-adjusted HR (95% CI)c | 1.0 | 1.83 (1.06, 3.16) | 1.35 (0.83,2.18) | 1.36 (0.79, 2.35) | 1.05 (0.47, 2.33) | 0.71 |
| Multivariable 1 HR (95% CI)d | 1.0 | 1.85 (1.07, 3.20) | 1.31 (0.80, 2.13) | 1.27 (0.73, 2.21) | 0.98 (0.44, 2.21) | 0.56 |
| Multivariable 2 HR (95% CI)e | 1.0 | 1.83 (1.05, 3.17) | 1.27 (0.78, 2.07) | 1.20 (0.69, 2.09) | 0.98 (0.44, 2.21) | 0.92 |
NOTE: The total number of cases in the pack years of smoking analysis differs from the alcohol analysis (n = 284 vs n = 305) due to the number of men with missing values for smoking and alcohol at baseline.
a P value for trend calculated using the median value in each category of alcohol consumption as a continuous variable in the regression models
b Includes 27 cases of bleeding of unknown etiology and 9 cases of small bowel bleeding
c Adjusted for age in years and study period in 2-year intervals and using simple updating to examine smoking status.
d Adjusted for alcohol (none, 1–4 g/day, 5–14 g/day, 15–29 g/day, 30+ g/day), body mass index (<21, 25–29, 30–31, ≥32 kg/m2), physical activity (quintiles), regular use of aspirin (yes/no), regular use of NSAIDs (yes/no); using simple updating to examine smoking status.
e Adjusted for multivariate model 1 plus medication use (proton pump inhibitors, H2 receptor antagonists, selective serotonin reuptake inhibitors, warfarin and/or clopidogrel) and comorbid disease (myocardial infarction, stroke or transient ischemic attack, rheumatoid arthritis, degenerative joint disease, peripheral vascular disease, chronic obstructive pulmonary disease, chronic kidney disease).
f Upper GI bleeding was defined as bleeding originating from the esophagus, stomach, or duodenum; lower GI bleeding was defined as bleeding arising from the colon or rectum