Eur J Gastroenterol Hepatol. 2003 Sep;15(9):995-1000.

Celiac.com 08/27/2004 - Past studies have demonstrated an association, but not a causal connection, between cigarette smoking and celiac disease. Using the Bradford Hill criteria British researchers have now established a causal connection. In a matched case-control study, the researchers utilized a questionnaire to obtain the smoking histories of 138 celiacs and 276 age-matched and sex-matched controls. The subjects were then categorized according to their pre-diagnosis cigarette exposure, and it was found that 10% of celiacs, and 30% of the controls were smokers during this time. A biological gradient was demonstrated for total, recent and current cigarette exposure, and the greatest risk reduction related to current exposure. The researchers conclude:

"This study strengthens the case for a causal relationship between smoking and coeliac disease by demonstrating a strong, temporally appropriate and dose-dependent effect, thus meeting the Bradford Hill criteria. This suggests that cigarette smoking truly protects against the development of adult coeliac disease."

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