Year 1983: Smoking decreases the risk of ulcerative colitis

The relationship between smoking and ulcerative colitis is a well demonstrated fact today. In fact, stopping smoking is one of the environmental factors with the strongest causal relationship with the onset of ulcerative colitis. But in 1982, this relationship had not yet been elucidated. In 1983, two epidemiologists from the Boston University Hospital read with interest the “signals” in the form of cohort studies and clinical cases published that same year by various authors who found that smoking seemed to have a protective effect against the onset of ulcerative colitis. These data stimulated them to review the information from two large epidemiological studies that had been coordinated by their site in patients admitted to their hospital or hospitals from other countries about health habits, including smoking. Their results found solid evidence of the negative association between smoking and the prevalence of ulcerative colitis. It is not odd that this paper would be published in the “Medical Intelligence” section that existed at the time in the journal where the paper was published. What they could not confirm was the causality of said association (recalling the 9 Bradford Hall criteria), leaving their conclusions suspended pending the existence thereof, hoping that using nicotine in future studies would reverse ulcerative colitis. Later studies have corroborated the inverse relationship between smoking and ulcerative colitis, but have not demonstrated that administration of nicotine is an effective method of managing these patients. We must not forget that tobacco contains hundreds of chemical products that could be participating in this relationship.