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Robert F. Anda, MD, MS; David F. Williamson, MS, PhD; Luis G. Escobedo, MD, MPH; Patrick L. Remington, MD, MPH

Arch Intern Med. 1990;150(7):1437-1441.

Abstract
• Although multiple studies support a causal relationship between smoking and peptic ulcers in men, data for women are limited. Therefore, we used data from the First National Health and Nutrition Examination Survey Epidemiologic Follow-up Study, a nationally representative prospective study of US adults, to evaluate the impact of smoking on the incidence of peptic ulcers in women. The study cohort included 2851 women who had not been diagnosed as having a peptic ulcer prior to the baseline interview. Among these women, 140 (4.9%) developed peptic ulcer disease. During 12.5 years of follow-up, the estimated cumulative incidence of ulcers was 10.0% for current smokers, 6.4% for former smokers, and 5.4% for never smokers. After adjusting for age, education, regular aspirin use, coffee consumption, and use of alcohol, current smokers were 1.8 times more likely to develop ulcers than never smokers (95% confidence interval, 1.2 to 2.6); the risk of peptic ulcer increased as the amount smoked increased. During the time of this study, we estimate that approximately 20% of incident peptic ulcer cases among US women were attributable to cigarette smoking.

(Arch Intern Med. 1990;150:1437-1441)

Author Affiliations
From the Office of Surveillance and Analysis (Drs Anda and Escobedo) and the Division of Nutrition (Dr Williamson), Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, Atlanta, Ga; and the Bureau of Community Health and Prevention, Wisconsin Division of Health, Madison (Dr Remington).

Footnotes
Accepted for publication March 7,1990.

Reprint requests to the Office of Surveillance and Analysis, Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, 1600 Clifton Rd NE, Atlanta, GA30333 (Dr Anda).

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