P2040 - Second-hand Smoke: A Silent Culprit Behind Peptic Ulcer Disease

Award: ACG Presidential Poster Award

Sweta Sahu, MBBS¹, Sadaf Iftikhar, MBBS², Smruti Karale, MBBS³, Aishwar Dixit, MBBS⁴, Simardeep Singh, MBBS⁵
1J.J.M. Medical College, Bhubaneswar, Orissa, India; 2Akhtar Saeed Medical and dental college, Lahore, Punjab, Pakistan; 3Government Medical College, Kolhapur, Maharashtra, Balitmore, MD; 4Baba Ramdev Das Medical College, Gorakhpur, Uttar Pradesh, India; 5MedStar Georgetown University Hospital, Baltimore, MD

Introduction: Peptic ulcer disease (PUD) is a prevalent gastrointestinal disorder with multifactorial etiologies. While direct smoking is a known risk factor, the impact of secondhand smoke (SHS) is understudied. Our retrospective case-control study investigates the association between SHS exposure and PUD.

Methods: We conducted a retrospective case-control study at a tertiary care center (Jan 2022–Oct 2024) including 524 PUD cases (diagnosed via endoscopy/imaging) and 524 age- and sex-matched controls without GI complaints. Data on secondhand smoke (SHS) exposure were collected via structured interviews, categorizing duration as < 5, 5–10, and > 10 hours/week. Additional variables (H. pylori, NSAID use, alcohol, comorbidities) were extracted from records. Conditional logistic regression was used to calculate adjusted odds ratios (ORs) and 95% CIs for the association between SHS exposure and PUD. Subgroup analyses examined SHS duration and PUD risk, while chi-square tests assessed links between SHS and PUD complications like bleeding ulcers.

Results: SHS exposure was significantly more prevalent in cases (68.5%) compared to controls (43.1%; χ² = 94.63, p < 0.001). Adjusted logistic regression revealed SHS exposure as an independent risk factor for PUD (OR: 1.48; 95% CI: 1.19–1.76; p < 0.001). Subgroup analysis showed a dose-response relationship. Individuals exposed to >10 hours/week of SHS had an OR of 1.41 (95% CI: 1.05–1.77), while those exposed 5–10 hours/week had an OR of 1.50 (95% CI: 0.91–2.10). Exposure < 5 hours/week showed an OR of 1.37 (95% CI: 0.68–2.06). Although not statistically significant, exposure durations < 10 hours/week showed a consistent trend toward increased risk. SHS exposure was not significantly associated with severe PUD complications, such as bleeding ulcers (χ² = 0.59; p = 0.44).

Discussion: Secondhand smoke constitutes an independent risk factor for peptic ulcer disease, with evidence indicating a dose-response relationship. Our findings emphasize the necessity for focused public health interventions aimed at decreasing SHS exposure and its effects on gastrointestinal health. Subsequent investigations have to examine the biological mechanisms that underpin this association.

Disclosures:
Sweta Sahu indicated no relevant financial relationships.
Sadaf Iftikhar indicated no relevant financial relationships.
Smruti Karale indicated no relevant financial relationships.
Aishwar Dixit indicated no relevant financial relationships.
Simardeep Singh indicated no relevant financial relationships.

Sweta Sahu, MBBS¹, Sadaf Iftikhar, MBBS², Smruti Karale, MBBS³, Aishwar Dixit, MBBS⁴, Simardeep Singh, MBBS⁵. P2040 - Second-hand Smoke: A Silent Culprit Behind Peptic Ulcer Disease, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.