Smoking as a cofactor for causation of chronic pancreatitis: A meta-analysis

Angelo Andriulli, Edoardo Botteri, Piero L. Almasio, Italo Vantini, Generoso Uomo, Patrick Maisonneuve

Research output: Contribution to journalArticlepeer-review


Objectives: To assess the evidence for tobacco smoking as a risk factor for the causation of chronic pancreatitis. Methods: We performed a meta-analysis with random-effects models to estimate pooled relative risks (RRs) of chronic pancreatitis for current, former, and ever smokers, in comparison to never smokers. We also performed dose-response, heterogeneity, publication bias, and sensitivity analyses. Results: Ten case-control studies and 2 cohort studies that evaluated, overall, 1705 patients with chronic pancreatitis satisfied the inclusion criteria. When contrasted to never smokers, the pooled risk estimates for current smokers was 2.8 (95% confidence interval [CI], 1.8-4.2) overall and 2.5 (95% CI, 1.3-4.6) when data were adjusted for alcohol consumption. A dose-response effect of tobacco use on the risk was ascertained: the RR for subjects smoking less than 1 pack per day was 2.4 (95% CI, 0.9-6.6) and increased to 3.3 (95% CI, 1.4-7.9) in those smoking 1 or more packs per day. The risk diminished significantly after smoking cessation, as the RR estimate for former smokers dropped to a value of 1.4 (95% CI, 1.1-1.9). Conclusions: Tobacco smoking may enhance the risk of developing chronic pancreatitis. Recommendation for smoking cessation, besides alcohol abstinence, should be incorporated in the management of patients with chronic pancreatitis.

Original languageEnglish
Pages (from-to)1205-1210
Number of pages6
Issue number8
Publication statusPublished - Nov 2010


  • alcohol
  • chronic pancreatitis
  • cigarette
  • meta-analysis
  • nicotine
  • smoking

ASJC Scopus subject areas

  • Hepatology
  • Internal Medicine
  • Endocrinology
  • Endocrinology, Diabetes and Metabolism


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