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Cohort study
Smoking cessation improves Crohn's disease outcomes regardless of the use of anti-TNF or immunomodulator
  1. Rupert W Leong1,
  2. Aladdin O Alswaifi2
  1. 1Concord Hospital, Sydney, New South Wales, Australia
  2. 2Saudi German Hospital Asir, Asir, Saudi Arabia
  1. Correspondence to Professor Rupert W Leong, Gastroenterology and Liver Services, Concord Repatriation General Hospital, Sydney, NSW 2139, Australia; rupertleong{at}

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Commentary on: OpenUrlCrossRefPubMed.


Smoking is the most well-studied environmental risk factor of inflammatory bowel diseases (IBDs). Ulcerative colitis is less prevalent in smokers and the converse is true for Crohn's disease (CD). Smoking has a detrimental effect on the course of CD including worse disease course, increased need for surgery, more frequent need for maintenance medications and higher need for biological agents.1–3 Smokers were found to have a significantly decreased survival free of stricturing disease or perianal complications, and had a higher rate of thiopurine therapy requirement.4 The benefit of smoking cessation on CD was …

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  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.