Abstract
Objective: There is limited data on cigarette smoking and the risk of acute pancreatitis (AP). We evaluated the influence of cigarette smoking on AP risk and clinical presentation in a large cohort of Veteran’s Administration (VA) patients.
Methods: Retrospective study of VA patients from 1998 to 2007. Exclusion criteria included (I) history of chronic pancreatitis (n=3222) or gallstones (n=14,574) and (2) age younger than 15 years (n=270). A 2-year washout period was used to exclude patients with pre-existing recurrent AP.
Results: The study included 484,624 patients. From 2001 to 2007, a total of 6799 (1.4%) patients had AP. Alcohol (risk ratio, 4.20) and smoking (risk ratio, 1.78) were independent significant risk factors of AP on multi-pic regression analysis. Smoking increased the risk of AP in both nonalcoholics (0.57% vs 1.1%) and alcoholics (2.6% vs 4.1%). Smoking was associated with younger mean age at first episode of AP and higher likelihood of recurrent AP (^4 episodes) in both nonalcoholics and alcoholics. The interval between recurrent episodes was not altered by alcohol or smoking.
Conclusions: In a large cohort of VA patients, smoking is an independent risk factor for AP and augmented the effect of alcohol on the risk, age of onset, and recurrence of AP.
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