Search resultsAlcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis
Title
Alcohol consumption, cigarette smoking, and the risk of recurrent acute and chronic pancreatitis
Publication type
Journal Article
Year of Publication
2009
Authors
Journal
Archives of Internal Medicine
Volume
169
Issue
11
Pagination
1035 - 1045
Date published
2009
ISBN
00039926 (ISSN)
Keywords
Acute Disease, acute pancreatitis, Adult, alcohol consumption, Alcohol Drinking, article, Chronic Disease, chronic pancreatitis, cigarette smoking, controlled study, Female, human, Humans, major clinical study, male, Middle Aged, Pancreatitis, patient coding, prevalence, priority journal, Recurrence, recurrent disease, risk assessment, Risk Factors, self report, smoking, United States
Abstract
Background: Recurrent acute pancreatitis (RAP) and chronic pancreatitis (CP) are associated with alcohol consumption and cigarette smoking. The etiology of RAP and CP is complex, and effects of alcohol and smoking may be limited to specific patient subsets. We examined the current prevalence of alcohol use and smoking and their association with RAP and CP in patients evaluated at US referral centers. Methods: The North American Pancreatitis Study 2, a multicenter consortium of 20 US centers, prospectively enrolled 540 patients with CP, 460 patients with RAP, and 695 controls from 2000 to 2006. Using selfreported monthly alcohol consumption during the maximum lifetime drinking period, we classified subjects by drinking status: abstainer, light drinker (≤0.5 drink per day), moderate drinker (women,>0.5 to 1 drink per day; men, >0.5 to 2 drinks per day), heavy drinker (women, >1 to <5 drinks per day; men, >2 to <5 drinks per day), or very heavy drinker (≥5 drinks per day for both sexes). Smoking was classified as never, past, or current and was quantified (packs per day and pack-years). Results: Overall, participants' mean (SD) age was 49.7 (15.4) years; 87.5% were white, and 56.5% were women. Approximately one-fourth of both controls and patients were lifetime abstainers. The prevalence of very heavy drinking among men and women was 38.4% and 11.0% for CP, 16.9% and 5.5% for RAP, and 10.0% and 3.6% for controls. Compared with abstaining and light drinking, very heavy drinking was significantly associated with CP (odds ratio, 3.10; 95% confidence interval, 1.87-5.14) after controlling for age, sex, smoking status, and body mass index. Cigarette smoking was an independent, dose-dependent risk factor for CP and RAP. Conclusions: Very heavy alcohol consumption and smoking are independent risks for CP. A minority of patients with pancreatitis currently seen at US referral centers report very heavy drinking.