Summary
Introduction Tobacco smoking increases the risk of gastro-oesophageal reflux symptoms (GORS), but whether tobacco smoking cessation decreases GORS is unclear.
Aims and methods The aim of this study was to clarify if tobacco smoking cessation decreases GORS. The study was based on the Nord-Trøndelag health study (HUNT), a prospective population-based cohort study from Nord-Trøndelag County, Norway. All residents of the county from 20 years of age were invited. The study included 29,610 individuals (61% response rate) who reported GORS status in 1995-7 and 2006-9. The association between quitting or reducing daily tobacco smoking and GORS was assessed by logistic regression, providing odds ratios (ORs) with 95% confidence intervals (CIs). The analyses were stratified by use of antireflux medication (proton pump inhibitors, histamine-2-receptor antagonists and antacids) and body mass index (BMI), and the results were adjusted for sex, age, alcohol consumption, education, and physical exercise.
Results Among individuals using at least weekly antireflux medication, quitting or reducing daily tobacco smoking was associated with a nearly 2-fold improvement of GORS from severe to no or minor complaints (OR 1.78, 95% CI 1.07 to 2.97), compared with individuals still smoking daily (Table). The association was over 5-fold among individuals within the normal range of BMI (OR 5.67, 95% CI 1.36 to 23.64), but no association was found among overweight individuals (Table). There was no association between quitting or reducing daily tobacco smoking and GORS status among individuals with minor GORS (data not shown) or individuals using less than weekly antireflux medication (Table).
Conclusion Quitting or reducing daily tobacco smoking improved severe GORS in individuals of normal BMI using antireflux medication at least weekly. This might be useful in the treatment of GORS in these patients and smoking cessation should be advised.
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