S3306 Impact of COVID-19 Pandemic on Smoking Habits in Patients With Inflammatory Bowel Diseases

Abstract

Introduction: Smoking negatively impacts disease progression in Crohn’s disease (CD). Patients who start or continue smoking after CD diagnosis are at risk for poorer outcomes, higher therapeutic requirements, and have higher rates of relapse often requiring surgery. Race, gender, socioeconomic factors, and stressors all affect smoking status in the general population but have not been explored in patients with inflammatory bowel diseases (IBD). Importantly, smokers are at an increased risk of complications from COVID-19 infection. This study aims to determine the risk factors for change in smoking habits in patients with IBD during the COVID-19 pandemic. Methods: Surveys were sent via email to 1589 patients with an electronic medical record coded diagnosis of IBD who were seen at our IBD clinic between January 2017 and September 2020. Those who self-identify as active or former smokers were invited to complete the unpaid, anonymous, online survey regarding demographics, socioeconomic factors, IBD disease phenotype, general anxiety, and smoking habits during the COVID-19 pandemic. Results: One hundred and thirty-nine participants completed the survey. One hundred and three participants either remained non-smokers or did not change the amount they were smoking, 22 started smoking again after previous cessation or increased smoking, and 10 stopped smoking, switched to vaping, or decreased the amount they were smoking. Statistically significant independent risk factors by Fisher’s exact test for change in smoking habits during the COVID-19 pandemic revealed both age 18-34 years (P= 0.011) and never married (p< 0.001) as most likely to change smoking amount. Those with CD (P= 0.041) were least likely to decrease smoking amount. Frequency of anxiety (P= 0.013), preoccupation with anxiety (P= 0.003), nervousness (P= 0.036), uneasiness (P= 0.034) and feeling tense (P= 0.021) were associated with increased smoking during COVID-19 pandemic. Conclusion: Smoking is known to have a negative impact on CD disease progression. In our cohort, participants with CD were least likely to decrease smoking amount during COVID-19 pandemic. Participants with frequent anxiety, preoccupation with anxiety, nervousness, uneasiness, and tension reported increased smoking during the pandemic. Routine screening for anxiety and smoking habits should be performed in all IBD clinical visits.