Celiac.com 12/07/2015 - Could population changes in smoking habits help explain the change in incidence and prevalence of celiac disease?

Photo: Jefferson AdamsCould lower rates of cigarette smoking be contributing to higher rates of celiac disease?

It is pretty well documented that cigarette smokers have lower natural rates of celiac disease than the non-smoking population, which implies that tobacco might offer some measure of prevention with regard to celiac disease.

Now, a gastroenterologist is asking whether a reduction in public smoking levels might be associated with a rise in rates of celiac disease.

In a letter to the editors of the American Journal of Gastroenterology regarding the study "Incidence and prevalence of celiac disease and dermatitis herpetiformis in the UK over two decades: population-based study" by West et al., Dr. S. Veldhuyzen van Zanten, MD, PhD, of the Division of Gastroenterology, University of Alberta in Edmonton, Alberta, Canada, wonders whether lower rates of cigarette smoking in the preceding decades "might help explain the study findings."

Data from several studies regarding reduced celiac rates in cigarette smokers offer support for Dr. van Zanten’s line of thinking; including data that show a new diagnosis of celiac disease is made significantly less frequently in smokers than in non-smokers.

Interestingly, there also is some evidence that cigarette smoking might actually mask the clinical manifestations of celiac disease rather than prevent its occurrence. Either way, Dr. van Zanten's hypothesis would cast some interesting light on celiac disease if proven correct.

The good news is that Dr. van Zanten’s hypothesis is easy to test. Because Canada has such a large health care database, they can easily compare rates of smoking and celiac diagnosis, and adjust for necessary factors to give a better picture of any possible connection.

Sources:

  • Am J Gastroenterol. doi: 10.1038/ajg.2014.345
  • West J , Fleming KM , Tata LJ et al. Incidence and prevalence of celiac disease and dermatitis herpetiformis in the UK over two decades: population-based study . Am J Gastroenterol 2014 ; 109 : 757 – 68 
  • Snook JA , Dwyer L , Lee-Elliott C et al. Adult coeliac disease and cigarette smoking . Gut 1996 ; 39 : 60 – 2 .
  • Lear JT , English JSC . Adult coeliac disease, dermetitis herpetiformis and cigarette smoking. Gut 1997 ; 40 : 289 .
  • van Zanten SJOV . Case Report: Recurrent diarrhea and weight loss associated with cessation of smoking in a patient with undiagnosed celiac disease . Gut 2001 ; 49 : 588.
  • Office for National Statistics UK. Smoking prevalence among adults has declined by half since 1974. Part of General Lifestyle Survey, 2011. Released: 28 March 2013. http://www.ons.gov.uk/ons/rel/ghs/general-lifestyle-survey/2011/sty-smoking-report.html 

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