{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:37:54Z","timestamp":1787920674697,"version":"build-2784847793"},"reference-count":42,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100005188","name":"Tobacco-Related Disease Research Program","doi-asserted-by":"publisher","award":["T34FT7960"],"award-info":[{"award-number":["T34FT7960"]}],"id":[{"id":"10.13039\/100005188","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Therap Adv Gastroenterol"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>The impact of multiple substance use on the risk of pancreatitis remains underexplored.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Objective:<\/jats:title>\n            <jats:p>To systematically review peer-reviewed observational studies assessing the association of multiple substance use with the risk of acute pancreatitis (AP) or chronic pancreatitis (CP) in adults.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>We conducted a systematic review informed by the Preferred Reporting Items for Systematic Review and Meta-Analyses guideline.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Data sources and methods:<\/jats:title>\n            <jats:p>EMBASE, MEDLINE, and PsycINFO were searched up to March 2024. Reference lists of included studies were reviewed. From 5205 records identified, 181 relevant records were evaluated in full text. Studies evaluating the association of \u2a7e2 substances, including tobacco, alcohol, cannabis, and illicit substances, with AP or CP were included. Data were extracted by one reviewer, with quality control by a second reviewer. Quality assessments were independently conducted by two reviewers, with differences resolved by a third.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>\n              Of 11 included studies, 6 investigated AP as the outcome and 5 examined CP. Among AP studies, 5 comparing smoking and alcohol to alcohol-only use showed high heterogeneity (\n              <jats:italic>I<\/jats:italic>\n              <jats:sup>2<\/jats:sup>\n              \u2009=\u200990.9%), with relative risks (RRs) from 1.40 to 11.40. One study examining cannabis and alcohol versus alcohol found a lower risk of AP in cannabis users. Among CP studies, four comparing smoking and alcohol to alcohol-only use were heterogeneous (\n              <jats:italic>I<\/jats:italic>\n              <jats:sup>2<\/jats:sup>\n              \u2009=\u200981%) with odds ratios 1.21\u201331.50. Where examined, smoking increases the risk of AP and CP in a dose-dependent fashion. Heavy alcohol users demonstrated a significant increase in CP risk across all smoking categories in one study.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion:<\/jats:title>\n            <jats:p>Combined alcohol and tobacco use increases pancreatitis risk compared to single substance use, despite heterogeneity in RRs and exposure definitions. Evidence suggests a dose-dependent impact of smoking on pancreatitis risk when added to alcohol. Studies on the impact of a combination of other substance use on pancreatitis risk are needed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Trial registration (PROSPERO):<\/jats:title>\n            <jats:p>CRD42024503677.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1177\/17562848251365030","type":"journal-article","created":{"date-parts":[[2025,8,25]],"date-time":"2025-08-25T10:15:02Z","timestamp":1756116902000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Multiple substance use and the risk of pancreatitis: a systematic review"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8236-7913","authenticated-orcid":false,"given":"Esther A.","family":"Adeniran","sequence":"first","affiliation":[{"name":"Department of Biomedical Sciences, Cedars-Sinai Medical Center, 6500 Wilshire Blvd, 15th Floor, 1544B, Los Angeles, CA 90048, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhiraj","family":"Yadav","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Han","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon K.","family":"Lo","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Pandol","sequence":"additional","affiliation":[{"name":"Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christie Y.","family":"Jeon","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,25]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.07.066"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(16)30004-8"},{"key":"e_1_3_4_4_2","first-page":"387","article-title":"Alcohol as a risk factor for pancreatitis. A systematic review and meta-analysis","volume":"10","author":"Irving HM","year":"2009","unstructured":"Irving HM, Samokhvalov AV, Rehm J. Alcohol as a risk factor for pancreatitis. A systematic review and meta-analysis. JOP 2009; 10: 387\u2013392.","journal-title":"JOP"},{"key":"e_1_3_4_5_2","first-page":"632","article-title":"Acute pancreatitis","volume":"90","author":"Quinlan JD.","year":"2014","unstructured":"Quinlan JD. Acute pancreatitis. Am Fam Physician 2014; 90: 632\u2013639.","journal-title":"Am Fam Physician"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.10.017"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-020-01859-5"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpg.2007.10.007"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pan.2019.09.004"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.24095\/hpcdp.42.2.01"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13929"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2011-300566"},{"key":"e_1_3_4_13_2","first-page":"577","article-title":"The use of alcohol, tobacco, illegal drugs and medicines: an estimate of consumption and substance-related disorders in Germany","volume":"116","author":"Atzendorf J","year":"2019","unstructured":"Atzendorf J, Rauschert C, Seitz NN, et al. The use of alcohol, tobacco, illegal drugs and medicines: an estimate of consumption and substance-related disorders in Germany. Dtsch Arztebl Int 2019; 116: 577\u2013584.","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2019.02.035"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.08.036"},{"key":"e_1_3_4_16_2","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page MJ","year":"2021","unstructured":"Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ 2021; 372: n71.","journal-title":"BMJ"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-072254"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2018.07.015"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006676-199309000-00007"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006676-198711000-00012"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17238895"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare11182515"},{"key":"e_1_3_4_23_2","volume-title":"R: a language and environment for statistical computing","author":"R Core Team","year":"2022","unstructured":"R Core Team. R: a language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing, 2022."},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.1186"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.53350\/pjmhs22163227"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2015.12.040"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1159\/000114868"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2004.04143.x"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000000364"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006676-200008000-00001"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2009.125"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1097\/MPA.0000000000000657"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2017.10.031"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-019-0158-2"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers7020723"},{"key":"e_1_3_4_36_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0078853"},{"key":"e_1_3_4_37_2","doi-asserted-by":"publisher","DOI":"10.1152\/ajpgi.00138.2012"},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2021-326853"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.annepidem.2010.01.003"},{"key":"e_1_3_4_40_2","first-page":"137","article-title":"Cannabinoids in acute gastric damage and pancreatitis","volume":"57","author":"Dembinski A","year":"2006","unstructured":"Dembinski A, Warzecha Z, Ceranowicz P, et al. Cannabinoids in acute gastric damage and pancreatitis. J Physiol Pharmacol 2006; 57(Suppl. 5): 137\u2013154.","journal-title":"J Physiol Pharmacol"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.02.035"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.3389\/fnmol.2017.00014"},{"key":"e_1_3_4_43_2","article-title":"Cannabis-based medicines for chronic neuropathic pain in adults","volume":"3","author":"Mucke M","year":"2018","unstructured":"Mucke M, Phillips T, Radbruch L, et al. Cannabis-based medicines for chronic neuropathic pain in adults. Cochrane Database Syst Rev 2018; 3: CD012182.","journal-title":"Cochrane Database Syst Rev"}],"container-title":["Therapeutic Advances in Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562848251365030","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17562848251365030","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17562848251365030","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T01:16:51Z","timestamp":1756343811000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17562848251365030"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":42,"alternative-id":["10.1177\/17562848251365030"],"URL":"https:\/\/doi.org\/10.1177\/17562848251365030","relation":{},"ISSN":["1756-2848","1756-2848"],"issn-type":[{"value":"1756-2848","type":"print"},{"value":"1756-2848","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]},"article-number":"17562848251365030"}}