Smoking and pancreatitis: meta-analysis points to dose-dependent risk

  • Pancreatology
  • 11 Sep 2019

  • International Clinical Digest
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Takeaway

  • Patients who smoke tobacco are more likely to develop acute and chronic pancreatitis.
  • There appears to be a dose-response relationship between smoking and pancreatitis risk.

Why this matters

  • Some, but not all, studies have shown increased risk for pancreatitis among smokers, and a dose-response relationship has been unclear.

Study design

  • Researchers analysed 10 prospective studies reporting adjusted relative risk (RR) estimates and 95% CIs for associations between tobacco smoking and pancreatitis.
  • They calculated summary RRs, using a random effects model.
  • Funding: South-East Regional Health Authority of Norway; Imperial College London.

Key results

  • The summary RRs for acute pancreatitis by smoking status were:
    • 1.49 for current smokers (95% CI, 1.29-1.72; I2=67.9%; n=7).
    • 1.24 for former smokers (95% CI, 1.15-1.34; I2=0%; n=7).
    • 1.39 for ever smokers (95% CI, 1.25-1.54; I2=68.9%; n=7).
  • Analysis suggested dose-response relationships in current smokers, with the following RRs:
    • 1.30 per 10 cigarettes per day (95% CI, 1.18-1.42; I2=42.3%; n=3).
    • 1.13 per 10 pack-years (95% CI, 1.08-1.17; I2=13.7%; n = 4).
  • Results were similar for chronic pancreatitis and acute/chronic pancreatitis combined.

Limitations

  • High heterogeneity in certain analyses.
  • More studies are needed to clarify associations among tobacco smoking, dose, years since cessation, and risk for pancreatitis subtypes.