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Quitting smoking reduces HS risk


Photo by: Myriams-Fotos via Pixabay

Recent research has found smoking cessation significantly reduced the risk of developing hidradenitis suppurativa (HS).


The findings were published online in JAMA Dermatology (Aug. 21, 2024).


In the article, the authors note that while tobacco smoking is an established risk factor for HS, there are limited studies on the effects of smoking cessation on the condition.


To explore this question, researchers enrolled participants from the Korean National Health Insurance Service database who had undergone two consecutive biennial health examinations (2004-2005 and 2006-2007) as the primary cohort. Within the primary cohort, the secondary cohort comprised individuals who underwent all biennial health examinations throughout the follow-up period and maintained the same smoking status from 2006 to 2007 to the end of the follow-up period.


Of the 6,230,189 participants enrolled, the mean (SD) age was 47.2 (13.5) years, and 55.6% were male. During 84,457,025 person-years of follow-up, 3,761 HS events occurred.

In the primary cohort, the investigators saw a lower HS risk among those who were confirmed to smoke initially but quit by the second checkup (adjusted hazard ratio [AHR], 0.68; 95% CI, 0.56-0.83), those who maintained cessation status throughout (AHR, 0.67; 95% CI, 0.57-0.77), and those who reported never smoking at either checkup (AHR, 0.57; 95% CI, 0.52-0.63) compared to those who consistently reported active smoking at both checkups.


Those who initially quit smoking but resumed by the second checkup and those who had no previous smoking history but started at the second checkup exhibited similar HS risk as sustained smokers.


The secondary cohort results aligned with those of the primary cohort, showing a more pronounced risk reduction with smoking cessation (AHR, 0.57; 95% CI, 0.39-0.83).


Considering time-smoking interaction, the cumulative incidence and the risk of HS in smoking quitters were similar to those in sustained smokers in the early stages of observation.


However, three to four years after smoking cessation, the rate slowed down, resembling that of never smokers, and there was a statistically significant decrease in the risk that persisted (between three and six years from the index date: AHR, 0.58; 95% CI, 0.36-0.92; and ≥12 years from the index date: AHR, 0.70; 95% CI, 0.50-0.97). New smokers initially paralleled never-smokers but accelerated after two to three years, reaching sustained smokers’ levels.

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