From the Guidelines
Smoking is a significant risk factor for pancreatitis, and quitting smoking is strongly recommended to prevent and manage the disease. According to the most recent and highest quality study, heavy smoking increases the risk of developing chronic pancreatitis, with a relative risk of 2-3 times higher compared to non-smokers 1. The toxic chemicals in cigarettes damage the pancreas through several mechanisms, including increasing inflammation, altering pancreatic secretions, causing oxidative stress, and promoting fibrosis (scarring) of pancreatic tissue.
Risk Factors for Pancreatitis
The main causes of chronic pancreatitis include excess alcohol consumption, pancreatic obstruction, pancreas divisum, cystic fibrosis, hypercalcaemia, autoimmunity, genetic mutations, and hypertriglyceridaemia 1. However, smoking is also a significant risk factor, and quitting smoking can slow the progression of chronic pancreatitis and reduce the frequency and severity of acute attacks.
Prevention and Management
For prevention and management of pancreatitis, complete smoking cessation is strongly recommended 1. Patients with pancreatitis or those at risk should seek support for smoking cessation through nicotine replacement therapy, prescription medications like varenicline or bupropion, and behavioral counseling to improve their pancreatic health. The benefits of quitting smoking outweigh the risks, and it is essential to prioritize smoking cessation to reduce the risk of pancreatitis and improve overall health.
Key Findings
- Heavy smoking increases the risk of developing chronic pancreatitis, with a relative risk of 2-3 times higher compared to non-smokers 1
- Smoking damages the pancreas through several mechanisms, including increasing inflammation, altering pancreatic secretions, causing oxidative stress, and promoting fibrosis (scarring) of pancreatic tissue
- Quitting smoking can slow the progression of chronic pancreatitis and reduce the frequency and severity of acute attacks 1
- Patients with pancreatitis or those at risk should seek support for smoking cessation through nicotine replacement therapy, prescription medications, and behavioral counseling to improve their pancreatic health 1
From the Research
Association between Smoking and Pancreatitis
- The relationship between smoking and pancreatitis has been investigated in several studies, with evidence suggesting a positive association between cigarette smoking and the development of pancreatitis 2, 3, 4, 5.
- A prospective population-based study found that the risk of non-gallstone-related acute pancreatitis was more than double among current smokers with ≥20 pack-years of smoking compared to never-smokers 2.
- A systematic review and meta-analysis of prospective studies found that tobacco smoking increased the risk of acute and chronic pancreatitis, with a dose-response relationship between increasing amount of tobacco smoked and pancreatitis risk 4.
- Another systematic review and meta-analysis found that both current and former smoking were associated with an increased risk for acute pancreatitis, with a summary relative risk of 1.74 for current smoking and 1.32 for former smoking 5.
Risk Factors and Smoking Cessation
- The duration of smoking rather than smoking intensity increased the risk of non-gallstone-related acute pancreatitis 2.
- After two decades of smoking cessation, the risk of non-gallstone-related acute pancreatitis was reduced to a level comparable to that of non-smokers 2.
- Smoking cessation may be a useful strategy for the management of pancreatitis, as suggested by a systematic review and meta-analysis 3.
- The evidence suggests that smoking is an important risk factor for non-gallstone-related acute pancreatitis, and early smoking cessation should be recommended as part of the clinical management of patients with acute pancreatitis 2, 3, 4, 5.