SYSTEMATIC REVIEW article
Front. Public Health
Sec. Substance Use Disorders and Behavioral Addictions
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1670320
This article is part of the Research TopicTobacco and Gastrointestinal DiseasesView all 3 articles
Passive smoking exposure and incidence and disease outcomes of inflammatory bowel disease: a systematic review and meta-analysis
Provisionally accepted
- 1Monash Health, Clayton, Australia
- 2Torrens University Australia - Flinders Street Campus Melbourne, Melbourne, Australia
- 3Monash University, Melbourne, Australia
- 4Department of Gastroenterology, Monash Health, Clayton, Australia
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Inflammatory bowel disease includes a range of chronic gastrointestinal disorders, most commonly Crohn's Disease (CD) and ulcerative colitis (UC). This systematic review and meta-analysis aims to evaluate the effect of passive smoking on incidence and disease outcomes of CD and UC. The initial search yielded 151 articles, with 32 studies deemed relevant for inclusion. Significant associations with passive smoking exposure were seen in 8 out of 20 studies for increased risk of CD and 3 out of 17 studies for UC. Meta-analysis found that passive smoking during childhood (OR 1.19, 95% CI 1.05-1.35) and exposure to smoking during pregnancy (OR 1.27, 95% CI 1.03-1.55) was associated with increase in odds of CD; however neither exposure was associated with an increased odds of UC. Associations with CD were also not confirmed in sensitivity analysis of higher-quality studies. Passive smoking was associated with disease complications including pouch-itis and backwash-ileitis in UC; while exposure to smoking during pregnancy was associated with hospitalisation and colorectal neoplasia in CD. There is inconclusive evidence surrounding the effects of passive smoking on need for medications and surgery. Findings of this review highlight the importance of educating on harms of passive smoking.
Keywords: inflammatory bowel disease, Cd, ulcerative colitis, passive smoking, Smoking, Tobacco, Pregnancy
Received: 21 Jul 2025; Accepted: 14 Oct 2025.
Copyright: © 2025 Mahajan, Gupta and Peterson. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Akanksha Mahajan, akanksha.mahajan2@monashhealth.org
Bhawna Gupta, bhawna.gupta@torrens.edu.au
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.