Smoking, Coffee, and Pancreatitis

Morton, Cynthia; Klatsky, Arthur L.; Udaltsova, Natalia
April 2004
American Journal of Gastroenterology;Apr2004, Vol. 99 Issue 4, p731
Academic Journal
OBJECTIVES: We studied relationships of cigarette smoking and coffee drinking to risk of pancreatitis.METHODS: This was a cohort study among 129,000 prepaid health plan members who supplied data about demographics and habits in 1978–85. Among 439 persons subsequently hospitalized for pancreatitis, probable etiologic associations were cholelithiasis (168/439= 38%), alcohol (125/439= 29%), idiopathic (110/430= 25%), and miscellaneous (36/439= 8%). Cox proportional hazards models with seven covariates (including alcohol intake) yielded relative risk estimates for smoking and coffee use.RESULTS: Increasing smoking was strongly related to increased risk of alcohol-associated pancreatitis, less related to idiopathic pancreatitis, and unrelated to gallstone-associated pancreatitis. Relative risks (95% confidence intervals, CI) of one pack per day (vsnever) smokers for pancreatitis groups were: alcohol= 4.9 (2.2–11.2,p<0.001), idiopathic= 3.1 (1.4–7.2,p<0.01), and gallstone= 1.3 (0.6–3.1). The relationship of smoking to alcohol-associated pancreatitis was consistent in sex and race subsets. Drinking coffee, but not tea, was weakly inversely related to risk only of alcohol-associated pancreatitis, with relative risk (95% CI) per cup per day= 0.85 (0.77–0.95;p= 0.003). Male sex, black ethnicity, and lower-educational attainment were other predictors of alcohol-associated pancreatitis.CONCLUSIONS: Cigarette smoking is an independent risk factor for alcohol-associated and idiopathic pancreatitis. Coffee drinking is associated with reduced risk of alcohol-associated pancreatitis. The data are compatible with the hypotheses that smoking may be toxic to the pancreas or may potentiate other pancreatic toxins while some ingredient in coffee may have a modulating effect.


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