{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:40:27Z","timestamp":1790196027964,"version":"4.1.0"},"reference-count":60,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2016,5,18]],"date-time":"2016-05-18T00:00:00Z","timestamp":1463529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Dr Falk CORE Bursary"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2016,7]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Tobacco smoking is associated with a reduced risk of developing ulcerative colitis (<jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content>). A high proportion of <jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content> patients perceive a benefit in disease outcomes secondary to smoking. However, the effects of smoking on the natural history of <jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content> are uncertain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To conduct a systematic review and meta\u2010analysis of the effects of tobacco smoking on the natural history of <jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A search of <jats:styled-content style=\"fixed-case\">MEDLINE<\/jats:styled-content>,<jats:styled-content style=\"fixed-case\"> EMBASE<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">EMBASE<\/jats:styled-content> classic was carried out (up to December 2015) to identify observational studies reporting data on smoking and rates of colectomy, flare of disease activity, proximal disease extension, and development of pouchitis following panproctocolectomy and ileal pouch\u2010anal anastomosis in patients with <jats:styled-content style=\"fixed-case\">UC<\/jats:styled-content>. Dichotomous data were pooled to obtain odds ratios (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>s), with 95% confidence intervals (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>s).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The search identified 16 eligible studies: five (2615 patients) studying colectomy; four (620 patients) reporting on flare of disease activity; four (687 patients) examining proximal disease extension and three (355 patients) assessing development of pouchitis. Compared with nonsmokers, the odds of colectomy (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a00.89; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.62\u20131.26), flare of disease activity (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a01.26; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.65\u20132.44), proximal extension of disease (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a00.57; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.20\u20131.66) or the development of pouchitis (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>\u00a0=\u00a00.57; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.21\u20131.53) were not significantly lower in smokers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Smoking may not improve the natural history of ulcerative colitis. Given the health benefits of smoking cessation and the lack of clear benefit in ulcerative colitis, smoking cessation advice should be incorporated into guidance on the management of ulcerative colitis.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.13663","type":"journal-article","created":{"date-parts":[[2016,5,19]],"date-time":"2016-05-19T04:39:15Z","timestamp":1463632755000},"page":"117-126","source":"Crossref","is-referenced-by-count":71,"title":["Systematic review with meta\u2010analysis: the effect of tobacco smoking on the natural history of ulcerative colitis"],"prefix":"10.1111","volume":"44","author":[{"given":"N.","family":"To","sequence":"first","affiliation":[{"name":"Leeds Gastroenterology Institute St. James's University Hospital Leeds UK"},{"name":"Leeds Institute of Biomedical and Clinical Sciences University of Leeds Leeds UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. 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