Matthew J. DiMagno; Eugene P. DiMagno


Curr Opin Gastroenterol. 2012;28(5):523-531. 

In This Article

Cigarette Smoking

Clearly, cigarette smoking associates with pancreatitis. In the past year two groups further defined the relationship among smoking, acute pancreatitis and chronic pancreatitis, emphasizing that patients with nongallstone-related acute pancreatitis or chronic pancreatitis of any cause should cease smoking.

In a Swedish population[2] current smoking increased nongallstone acute pancreatitis risk two-fold compared with never smokers and four-fold in current smokers who drank more than 400 g alcohol per month compared with lower alcohol quantities. In addition, smoking duration rather than the daily number of cigarettes increased the risk of nongallstone-related acute pancreatitis, and after stopping smoking for 20 years the risk of nongallstone acute pancreatitis was similar to nonsmokers. There was no association between smoking and gallstonerelated acute pancreatitis.

In a Danish study,[3] 24% of persons with acute pancreatitis progressed to chronic pancreatitis; the cause of acute pancreatitis was distributed equally between alcohol (48%) and idiopathic (47%). Independent of etiology, smoking was the most important factor influencing progression of acute pancreatitis to chronic pancreatitis. The mortality for persons with progressive acute pancreatitis was approximately six-fold greater than the normal population and approximately three-fold greater than persons with nonprogressive acute pancreatitis. Only one patient with gallstone acute pancreatitis progressed to chronic pancreatitis, confirming that gallstone acute pancreatitis does not lead to chronic pancreatitis.[4]