The Torments of Tobacco
The negative health effects of cigarette smoking have become common knowledge in recent decades, as continuing research charts its dangerous impact on the body. Smoking has been proven to harm organs, accelerate various reproductive risks, and is a primary cause of cardiovascular diseases, respiratory diseases, and many types of cancer—all debilitating conditions that can lead to death.
Crohn’s disease is more widespread among smokers than non-smokers and smokers with Crohn’s disease aren’t spared from tobacco’s raft of ill effects. Crohn’s patients who smoke put themselves in jeopardy for increasing the severity of their symptoms, complications, medication dosages, and likelihood for surgery.
Smoking can also reduce the effectiveness of medication, make Crohn's disease more active, and prevent remission. Moreover, post-surgery recurrence of Crohn’s symptoms will happen sooner and with greater intensity in smokers than in non-smokers. Finally, evidence indicates that smokers can develop high-risk colon polyps, the type that can become cancerous.
The Cold Turkey Conundrum
Taking the wealth of accumulated medical research into account, ceasing tobacco use would seem a wise decision for anyone—especially Crohn’s patients. Unfortunately, the reality is much more complicated because quitting abruptly can actually worsen Crohn’s symptoms and ignite flare-ups. Flare-ups, in turn, may act as stressors that can prompt a smoker to seek temporary relief by reaching for a cigarette. This situation may persuade a smoker with Crohn’s to conclude that they’re damned if they do quit smoking and damned if they don’t.
Understanding the nature of this chicken and egg relationship between cigarette smoking and Crohn’s can help transform the futility of such short-term thinking into the success of long-term, smoke-free solutions.
Quitting Smoking Aids & Crohn’s Disease
Although research indicates a causal effect between cigarette smoking and Crohn’s, no one is sure what the active agent linked to the disease is. Nicotine may be the culprit, as nicotine patches and nicotine chewing gum can also trigger flare-ups. These kinds of considerations highlight the importance of consulting your doctor on the best way to quit smoking.
Recent studies have shown that a therapeutic approach using Zyban, a prescription medication containing bupropion, can help Crohn’s patients quit smoking. Bupropion is an antidepressant that increases particular kinds of brain activity, and usually takes a month or more before its anti-smoking and antidepressant benefits take full effect. One controlled trial revealed that smoking cessation treatment using bupropion (either with or without a nicotine patch) yielded greater long-term smoking abstinence rates than treatment using only a nicotine patch.
Drowsiness, dizziness, and headaches are all side effects of bupropion, while dry mouth, excitability, excessive sweating, uncontrollable shaking, and constipation affect some users. Nausea, vomiting, and weight loss are other typical reactions that can easily go ignored because they’re also symptoms of Crohn’s disease. Other serious side effects may occur, so it’s best to discuss these with your doctor before using bupropion.
Although smoking cessation can be a “two steps forward, one step back” process, the consensus shows that within six months of quitting, ex-smokers experience significantly reduced rates of flare-ups—up to 65 percent fewer than smokers, rates equivalent to non-smokers. After one year of abstinence, health benefits prove even more compelling and long-lasting.
Crohn’s patients who are ready to give up cigarettes should ask their doctor for help in finding a smoking cessation specialist. Should the use of nicotine patches and/or antidepressants such as bupropion fail due to side effects, a specialist may guide the smoker with Crohn’s to try safer behavior modification strategies.