My jaw just about hit the floor when my GI doctor told me that several of his ex-smoker patients restarted the habit and went into remission for UC. And it’s not necessarily the nicotine; he advised that there is/are some other toxin(s) in tobacco smoke that UC doesn’t like. I was incredulous because I had never, ever heard a physician even consider informing their patient to think about resuming smoking–of course it was not a recommendation of his, and he specifically mentioned that. He was imparting some information he found interesting.
So I looked it up. And it’s indeed published by the NIH. Ironic that an MD would suggest considering restarting smoking (although officially AMA). Now we get into quality of life questions.
Low-dose smoking resumption in ex-smokers with refractory ulcerative colitis.
Emma Calabrese, Henit Yanai, Dmitry Shuster, David T Rubin, Stephen B Hanauer
Section of Gastroenterology, Hepatology and Nutrition, University of Chicago, Chicago, IL 60637, USA.
Journal of Crohn s and Colitis (Impact Factor: 3.56). 01/2012; 6(7):756-62. DOI: 10.1016/j.crohns.2011.12.010
Source: PubMed
ABSTRACT Ulcerative colitis (UC) is primarily a disease of non-smokers. Ex-smokers may have a more refractory disease course and anecdotal evidence in non-controlled clinical trials have suggested that smoking resumption, or the administration of nicotine, may ameliorate signs and symptoms of UC in ex-smokers. We report outcomes of ex-smokers with refractory UC who resumed low-dose cigarette smoking.
17 ex-smokers with refractory UC were identified. Clinical remission was defined as a disease activity index score of 0.
Two out of 17 patients refused the recommendation to resume smoking. Of the 15 patients who resumed smoking, the mean daily number of cigarettes was 8.6.
Fourteen out of those 15 patients who resumed smoking were able to maintain prolonged clinical remission off steroids. One out of the 15 patients failed to improve and required oral steroids. Another patient was compelled to quit smoking since he became addicted. His disease flared after maintaining a prolonged remission of 3 years and he eventually underwent surgery. Three out of these 15 patients switched from cigarettes smoking to nicotine compounds and continued to maintain remission.
Resumption of low dose smoking in a selected group of ex-smokers with refractory UC may ameliorate signs and symptoms. Quality of life, medication side effects, and smoking risk factors should all be considered and discussed with patients. Smokers should be meticulously followed for compliance with “low-dose” regimen and all associated smoking risks.
The only problem with that for me was that “low dose” talk. Impossible for me to modulate. Ah, well.