Maisonneuve P et al. (2005) Cigarette smoking accelerates progression of alcoholic chronic pancreatitis. Gut 54: 510–514

Alcohol consumption is known to be the principal cause of pancreatitis. Although smoking has also been implicated as a risk factor, its effects on the development of the disease have not been widely investigated.

Maisonneuve et al. conducted a retrospective, multicenter US and European cohort study in 934 patients of known smoking status with chronic alcoholic pancreatitis. The aim was to evaluate the impact of smoking on the age at diagnosis of pancreatitis, and on the development of pancreatic calcification (as diagnosed by abdominal radiography) and diabetes (defined as raised fasting blood glucose level or an abnormal glucose tolerance result). The analyses were adjusted for gender, age, center and alcohol consumption.

Mean age at diagnosis of pancreatitis was 4.7 years lower in smokers compared with non-smokers. At the time of diagnosis of pancreatitis, calcification was observed in 40% of males and 34% of females overall and was more prevalent in smokers than non-smokers. The presence of diabetes at diagnosis was noted in 21% of males and 20% of females and showed no association with smoking; however, development of diabetes after diagnosis occurred in a greater proportion of smokers than non-smokers. The degree of tobacco consumption (<1 pack/day or >1 pack/day) had no significant effect on the correlation between smoking and calcification or diabetes.

The authors conclude that smoking is an independent risk factor for earlier diagnosis of chronic alcoholic pancreatitis and the development of calcification and diabetes.