Cigarette Smoking Increases the Risk of Pancreatic Calcification in Late-Onset But Not Early-Onset Idiopathic Chronic Pancreatitis

Abstract

An association exists between cigarette smoking and pancreatitis owing to alcohol. We determined whether cigarette smoking affected the course of pancreatic calcification and insufficiency in idiopathic chronic pancreatitis. Medical records were analyzed of 24 persons with early- and 42 with late-onset idiopathic chronic pancreatitis who were diagnosed between 1976 and 1982 and then followed prospectively until 1985. Smoking equaled >5 pack-years before calcification or insufficiency or last follow-up. Mean follow-up after onset of chronic pancreatitis was 27 and 13 years in early- and late-onset idiopathic chronic pancreatitis, respectively. Incidence of calcification in the two groups was 58 and 43%, respectively. In early-onset idiopathic chronic pancreatitis, smokers and nonsmokers developed calcification at a similar rate and frequency (58%). In late-onset idiopathic chronic pancreatitis, smokers developed pancreatic calcifications faster (p < 0.001) and more frequently (83 vs. 13%, p < 0.001) than nonsmokers. The association between smoking and pancreatic calcification was independent of gender, body mass index, and exocrine or endocrine insufficiency. Smoking did not affect development of exocrine or endocrine insufficiency. Cigarette smoking increases the risk of pancreatic calcification of late- but not of early-onset idiopathic chronic pancreatitis. These data support encouraging cessation of smoking in chronic pancreatitis.

Risk factors for diabetes mellitus in chronic pancreatitis: A cohort of 2,011 patients

“…32 However, Imoto et al concluded that smoking did not affect DM development. 33 In our study, we did not find smoking as a risk factor for increasing the risk of DM in CP, though a significant difference in DM development was only found between smokers and non-smokers in univariate analysis (P ¼ 0.02).…”

Evidence-based clinical practice guidelines for chronic pancreatitis 2015

“…In addition, smoking increases the risks of developing chronic pancreatitis and pancreatic calcification. Abstinence from smoking may prevent the progression of chronic pancreatitis; therefore, giving smoking cessation guidance is recommended [66][67][68].…”

Italian consensus guidelines for chronic pancreatitis

“…Moreover, alcohol withdrawal is quite often not associated with smoking withdrawal. Retrospective data indicated a beneficial effect of smoking withdrawal to reduce/avoid pain and complications in chronic pancreatitis [32,33]. Experts recommend smoking withdrawal for patients with chronic pancreatitis [18].…”