How Smoking Affects Crohn’s Disease

You already know that smoking is really bad for your health. It can harm every part of your body, from your heart to your liver and lungs. It also makes you more likely to get Crohn’s disease, and it makes it worse and harder to treat, too.

Crohn’s disease causes inflammation and ulcers (sores) in your digestive system. Scientists are studying exactly how smoking makes the condition worse. It may happen because smoking lowers the intestine’s natural defenses, hampers blood flow to and from your intestines, and causes changes in the immune system that lead to inflammation. Some people inherit genes that make them more likely to get Crohn’s disease, and smoking may influence how those genes work. In those people, smoking can be a major part of making the disease worse.

If you have Crohn’s disease and smoke, you’re likely to:

  • Have up to 50% more flare-ups than nonsmokers
  • Have more severe complications, such as a fistula (an abnormal tunnel that forms from an ulcer into surrounding tissue)
  • Need surgery and follow-up surgery
  • Need more medicine to control the disease

More Surgeries?

Nearly half of people with Crohn’s disease will need at least one surgery, but that doesn’t cure the disease, and many people will need follow-up procedures. Smoking is the thing that's most likely to make you need more operations.

The negative effects depend on how much you smoke. Crohn’s disease is worse among people who smoke a lot. Also, women with Crohn’s disease have more severe negative effects from smoking than men. Doctors don’t know why that is.

Be a Quitter

Quitting smoking is one of the best things you can do for your health:

  • Your overall digestive health will improve.
  • Within a year of quitting, your chance of having flare-ups will go down.
  • You’ll be less likely to need medicine or have to take more.
  • You’ll be more likely to eat healthy food and adopt other habits that make Crohn’s easier to manage.
  • You'll reduce your risk for colon cancer.



Stress, Smoking, and Flare-Ups

Stress can make Crohn’s symptoms worse, and if smoking has been one of your go-to habits when you’re stressed out, you’ll want to find other ways to relax that also support your efforts to quit:

  • Exercise more, which can improve your mood and help manage Crohn’s.
  • Cut down on caffeine, which can make you feel anxious and worsen nicotine withdrawal symptoms.
  • Take a warm bath, stretch, or get a massage to release tension.
  • Take extra-good care of yourself: Get enough sleep, eat healthy food, and drink plenty of water.
  • Reach out to family and friends for support.
  • Talk to a counselor (even a few sessions may help) or take a stress management class.

Get Help

You don’t have to go it alone. A lot of people try several times before they kick the habit for good. It’s OK to need help with that. Ask your doctor about smoking cessation programs, medications, and support groups that can help you stay on track. There are also tools and apps online that support your efforts.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on March 08, 2020



MedlinePlus: “Smoking.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Crohn’s Disease.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Smoking and the Digestive System.”

Crohn’s & Colitis Foundation: “Managing Flares and Other IBD Symptoms.”

University of North Carolina School of Medicine: “Smoking Cessation and Crohn’s Disease.”

Mayo Clinic: “Crohn’s disease.”

University of Maryland Medical Center: “Crohn disease.”

World Journal of Gastroenterology: “Management of Crohn’s disease in smokers: Is an alternative approach necessary?”

Crohn’s & Colitis Foundation: “Stress and Anxiety.” “Coping With Stress Without Smoking,” “Create My Quit Plan.”

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