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Objectives

Tobacco exposure is an established risk factor for pancreatic cancer and chronic pancreatitis; however, its role in pancreatic insufficiency is not clear.

Methods

This controlled, cross-sectional study examined smokers and nonsmokers with no history of pancreatic disease. Histories and validated inventories of alcohol and tobacco use were obtained, and pancreatic insufficiency was assessed using the fecal elastase-1 assay.

Results

Of 7854 patients approached, 226 were interviewed and 200 enrolled. The rates of pancreatic insufficiency [18%(18/100)] and severe pancreatic insufficiency [10%(10/100)] were significantly higher in smokers than in controls [6%(6/100), P= 0.009 and 1%(1/100), P= 0.010, respectively]. On multivariate logistic regression, the risk of pancreatic insufficiency in smokers was significantly increased [odds ratio, 4.34 (1.37–13.75); P= 0.012], controlling for alcohol use and relevant …