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Smoking and Inflammatory Bowel Disease: A Meta-analysis

      OBJECTIVE

      To assess whether there is a true effect of smoking on the 2 most prevalent forms of inflammatory bowel disease (IBD): Crohn disease (CD) and ulcerative colitis (UC).

      METHODS

      For this meta-analysis, we searched multiple health care databases, including MEDLINE and EMBASE (January 1980 to January 2006), to examine the relationship between smoking and IBD. Keywords searched included smoking, inflammatory bowel disease, Crohn's disease, and ulcerative colitis. Data were abstracted using predefined inclusion and exclusion criteria. An odds ratio (OR) was recalculated for each study using the random-effects model, and a combined OR was calculated.

      RESULTS

      A total of 245 articles were obtained through an electronic search of health care databases. Thirteen studies examined the relationship between UC and smoking, whereas 9 examined the relationship between CD and smoking. We found evidence of an association between current smoking and CD (OR, 1.76; 95% confidence interval [CI], 1.40-2.22) and former smoking and UC (OR, 1.79; 95% CI, 1.37-2.34). Current smoking had a protective effect on the development of UC when compared with controls (OR, 0.58; 95% CI, 0.45-0.75).

      CONCLUSION

      This is the first meta-analysis, to our knowledge, to evaluate the relationship between smoking and IBD using accepted quality standards for meta-analysis reporting. Our meta-analyses confirm that smoking is an important environmental factor in IBD with differing effects in UC and CD. By using predefined inclusion criteria and testing for homogeneity, the current analysis provides an estimate of the effect of smoking on both these forms of IBD.
      CD (Crohn disease), CI (confidence interval), IBD (inflammatory bowel disease), OR (odds ratio), UC (ulcerative colitis)
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      • CORRECTION
        Mayo Clinic ProceedingsVol. 82Issue 7
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          Incorrect numbers: In the article by Mahid et al entitled “Smoking and Inflammatory Bowel Disease: A Meta-analysis,” published in the November 2006 issue of Mayo Clinic Proceedings (Mayo Clin Proc. 2006;81:1462-1471), incorrect numbers were published in Table 1 under the column headings “Smoking status of ulcerative colitis patients” and “Smoking status of controls.” Incorrect numbers were also published in Figure 2; under the column heading “No. of controls” in the “Lorusso et al60 1989” entry and the “Combined” entry in the top portion, the correct numbers are 35/72 and 3303/9972, respectively, and in the middle portion, the correct numbers are 12/49 and 1123/7792, respectively.
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