Lifetime Smoking History and Marijuana co-use in Patients With Alcohol-related Acute Pancreatitis.

Abstract

Objectives: Smoking increases the risk of the first episode of acute pancreatitis (AP), its recurrence, and progression to chronic pancreatitis. Co-use of cigarettes with marijuana may exacerbate health risks, complicating pancreatitis management. Our study aims to investigate the lifetime smoking history and co-use of cigarettes and marijuana in AP patients.

Methods: We analyzed smoking history and marijuana use data from a multicenter case-crossover study of alcohol-associated AP patients (n=145) recruited from June 2020 to June 2024. Lifetime cigarette use was categorized as: history of smoking <1 pack-per day [PPD], ≥1 PPD, and non-smokers. Age-based smoking prevalence was estimated across two birth cohorts (1956-1979 and 1980-1998). Risk factors for co-use were also assessed.

Results: Of the 143 participants enrolled and who completed smoking history interview, 76% were current smokers and 24% were former smokers. Median cumulative pack-years of smoking until enrollment was 20.4 years in ≥1 PPD smokers vs. 4.2 years in <1 PPD smokers (P<0.001). Peak smoking prevalence was higher in females born in 1980-1998 than females born in 1956-1979 (100% vs. 67%), while males showed an opposite trend (61% for 1956-1979 vs 52% for 1980-1998). Of all participants, 20% reported co-use of cigarettes and marijuana, 22% cigarette-only use, and 14% marijuana-only use. Trauma and stressor-related disorders were associated with a lower likelihood of co-use than cigarette-only use (AOR: 0.19, 95% CI: 0.05-0.63, P=0.010).

Conclusions: Smoking is highly prevalent in patients with alcohol-associated AP, many of whom also use marijuana. Tailored smoking cessation interventions are needed for AP patients.