Clinical status of ulcerative colitis in patients who smoke

Green, John T., Rhodes, J., Ragunath, K., Thomas, G. A. O., Williams, G. T., Mani, V., Feyerabend, C. and Russell, M. A. H. 1998. Clinical status of ulcerative colitis in patients who smoke. The American Journal of Gastroenterology 93 (9) , pp. 1463-1467. 10.1111/j.1572-0241.1998.00464.x

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Abstract

Objectives: Ulcerative colitis (UC) is largely a disease of nonsmokers. There are few patients who are current smokers, but we have identified a group and reviewed their clinical status, disease activity, and nicotine exposure to examine whether they remain well controlled while smoking. Methods: Fifty-one patients from three centers with verified UC were reviewed. Results: Thirty of the group were men; mean age 50 yr, with a mean age of onset of 37 yr. Twenty-two patients had proctosigmoid disease, 12 involvement of left colon, and 17 total colitis. All were current smokers; 41 were cigarette smokers averaging 17 daily. At the onset of colitis 30 were nonsmokers, 25 of them were ex-smokers and 19 developed colitis within 2 yr of stopping smoking. Twenty-eight believed smoking improved disease activity and none felt smoking had a detrimental effect on their UC. Eleven were receiving no medication for UC, 40 were receiving 5-ASA (5-aminosalicylic acid) preparations, and only two took oral steroids. All were in clinical remission, with the exception of one patient; mean St. Marks score was 1.5, out of a possible total of 22. Sigmoidoscopic grades were inactive in all patients except three. Histological assessment showed significant activity in only five. Median serum nicotine was 8 ng/ml (range, 0.4–24.4), median serum cotinine 180 ng/ml (range, 20–453), with corresponding salivary cotinine of 255 ng/ml (range, 34–683). Median rise in nicotine 2 min after a cigarette in 35 patients was 12.1 ng/ml (range, 0.4–44). Conclusions: Because most current smokers with UC have inactive disease, smoking may contribute to the clinical remission in these patients.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Schools > Medicine
Publisher:	Lippincott, Williams & Wilkins
ISSN:	0002-9270
Last Modified:	07 Aug 2026 14:15
URI:	https://orca.cardiff.ac.uk/id/eprint/188784

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