Smoking

These 3 studies did not find a strong causal link between smoking and adenocarcioma:

11 October 2013 No Significant Effects of Smoking or Alcohol Consumption on Risk of Barrett's Esophagus. "Smoking and alcohol were not strong or consistent risk factors for BE." (Digestive Diseases & Sciences)

12 September 2015 Pleiotropic analysis of cancer risk loci on esophageal adenocarcinoma risk. "After correcting for multiple testing, none of the tested 387 SNPs [single nucleotide polymorphisms] were statistically significantly associated with risk of EA or BE. No evidence of effect modification by smoking, BMI, or reflux/heartburn was observed." (Cancer epidemiology)

June 2014 Influence of Life Style Factors on Barrett's Oesophagus. "Conclusions. Long reflux time and family clustering of GOR seem to influence the development of Barrett's oesophagus. Smoking habits, alcohol consumption and BMI do not seem to have any impact on the development of Barrett's oesophagus." (Gastroenterology Research & Practice)

These 19 studies did find smoking to be a significant risk factor:

13 June 2019 Risk factors for Barrett's esophagus in young adults who underwent upper gastrointestinal endoscopy in a health examination center (full text) "Significant risk factors of BE in young adults are male sex, the presence of GERD symptoms, and smoking. The risk also increases with an increase in cumulative exposure to smoking." (Therapeutic Advances in Gastroenterology)

18 August 2018 Prediagnostic circulating markers of inflammation and risk of oesophageal adenocarcinoma: a study within the National Cancer Institute Cohort Consortium "This prospective study provides evidence of a link between systemic inflammation and oesophageal adenocarcinoma risk. In addition, this study provides the first evidence that indirect effects of excess adiposity and cigarette smoking, via systemic inflammation, increase the risk of oesophageal adenocarcinoma." (Gut)

15 June 2018 Natural History of Barrett's Esophagus. (full text) "The incidence of high-grade dysplasia and cancer in BE depends on segment length, gender, and age. The latter two likely indicate the duration of the presence of BE in an individual patient. Other factors that influence the incidence of dysplasia and cancer are smoking behavior and use of certain medications such as PPIs, statins, and NSAIDs. Surveillance of BE and treatment of dysplasia can impact the incidence of and mortality due to esophageal adenocarcinoma. This is of major benefit to a subgroup of BE patients." (Digestive Diseases & Sciences)

15 March 2018 Interactions Between Genetic Variants and Environmental Factors Affect Risk of Esophageal Adenocarcinoma and Barrett's Esophagus. (Full text pdf) "We aimed to identify single nucleotide polymorphisms (SNPs) that may modify the associations of body mass index (BMI), smoking, and gastroesophageal reflux disease (GERD), with risks of EA and BE." (Clinical Gastroenterology & Hepatology)

11 January 2018 A prospective cohort-study of 122 adult patients presenting to an otolaryngologist's office with globus pharyngeus. "The incidence of globus is 3.8% in the otolaryngologist's office. Female gender and concomitant foreign body sensation were predictive for presenting to the clinic even if symptom remission had occurred. Male gender, smoking and self-perceived breathing difficulties were predictive for persisting symptoms. Globus is an anxiety causing symptom, but reassurance is provided by clinical examination by the otolaryngologist." (Clinical Otolaryngologist)

19 December 2017 Development and Validation of a Model to Determine Risk of Progression of Barrett's Esophagus to Neoplasia. " During the follow-up period, 154 patients (5.7%) developed HGD or EAC, with an annual rate of progression of 0.95%. Male sex, smoking, length of BE, and baseline-confirmed low-grade dysplasia were significantly associated with progression." "We developed a scoring system (called progression of BE (PIB) score) based on male sex, smoking, length of BE, and baseline low-grade dysplasia) that identified patients with BE at low, intermediate, and high risk groups for HGD or EAC. This scoring system might be used in management of patients." (Gastroenterology)

25 October 2017 Gastroesophageal reflux disease among population of Arar City, Northern Saudi Arabia. "The rate of 61.8% was substantially high. Coffee drinking, stress, spicy food, prolonged use of NSAID, fatty meals and smoking were the reported risk factors." (Electronic Physician)

30 November 2017 Factors Associated with Progression of Barrett's Esophagus: A Systematic Review and Meta-analysis. "In a systematic review and meta-analysis, we associated older age, male sex, smoking, longer BE segment, and LGD with risk of progression of BE. Individuals with these features should undergo more intensive surveillance or endoscopic therapy. Smoking is a modifiable risk factor for cancer prevention in patients with BE." (Clinical Gastroenterology & Hepatology)

October 2017 Tobacco smoking, alcohol consumption and gastro-oesophageal reflux disease. " Tobacco smoking cessation reduces the risk of GORD symptoms and avoidance of alcohol is encouraged in individuals where alcohol consumption triggers reflux." (Best Practice & Research. Clinical Gastroenterology)

October 2016 Risk Factors for Barrett's Oesophagus. "Primary risk factors for BO include male gender, increased age, a family history of the disease, long-standing GORD, smoking, obesity (specifically determined by the waist-to-hip ratio as opposed to BMI), and Caucasian race. Alcohol consumption andHelicobacter pylori are not associated with the condition." (Gastrointestinal Tumors)

27 October 2016 Global DNA methylation patterns in Barrett’s esophagus, dysplastic Barrett’s, and esophageal adenocarcinoma are associated with BMI, gender, and tobacco use "Our findings suggest obesity and tobacco smoking may influence DNA methylation in the esophagus and raise the possibility that these risk factors affect the development of BE, dysplastic BE, and EAC through influencing the epigenetic status of specific loci that have a biologically plausible role in cancer formation." (Clinical Epigenetics)

2015 Improving the diagnosis and management of GORD in adults. "Abdominal obesity causes GORD by elevating intra-abdominal pressure, which promotes reflux and the development of hiatus hernia. GORD symptoms are increased by 70% among daily smokers who have been smoking for more than 20 years." (The Practitioner)

28 October 2015 The impact of lifestyle on Barrett's Esophagus: A precursor to esophageal adenocarcinoma. "Lifestyle factors did not appear to affect Barrett's Esophagus length but weight gains, smoking, and male gender were associated with a diagnosis at a significantly younger age." (Cancer Epidemiology)

26 July 2015 Impact of pre-diagnosis behavior on risk of death from esophageal cancer: a systematic review and meta-analysis. "Our findings suggest that a number of modifiable pre-diagnosis risk factors have a carry over effect on the risk of death from esophageal cancer. These include smoking, drinking alcohol, and BMI." (Cancer Causes & Control)

3 January 2015 Smoking as an independent determinant of Barrett's esophagus and, to a lesser degree, of reflux esophagitis. "Smoking seems to be an independent determinant of BE and, to a lesser degree, of E. The elevation in risk is independent from GERD and is already present in light cigarette smokers. Smoking cessation may reduce, but not remove this risk." (Cancer Causes & Control)

December 2014 Metformin use and the risk of esophageal cancer in barrett esophagus. "The three independent variables that predicted progression of Barrett esophagus to esophageal adenocarcinoma in our study were older age, smoking, and diabetes mellitus. Statin use showed protective effect against development of esophageal adenocarcinoma. Metformin use did not demonstrate any statistically significant protective effect." (Southern Medical Journal)

Cigarette smoking is a modifiable risk factor for Barrett's oesophagus. "smokers with reflux symptoms have about threefold higher risk of BO compared with nonsmokers, whereas discontinuing smoking is associated with a significant reduced risk" (United European Gastroenterology Journal Dec 2013)

March 2014 Tobacco Smoking Cessation and Improved Gastroesophageal Reflux "Tobacco smoking cessation was associated with improvement in severe GERS" (American Journal of Gastroenterology)

Page updated 14 February 2023