The role of smoking in peptic ulcer disease.

Cigarette smoking appears to be a risk factor for the development, maintenance, and recurrence of peptic ulcer disease. Smoking has an inconsistent effect on gastric acid secretion, but it does have other effects on upper gastrointestinal function that could contribute to the pathogenesis of peptic ulcer disease. These include (a) interference with the action of histamine-2 antagonists, (b) acceleration of gastric emptying of liquids, (c) promotion of duodenogastric reflux, (d) inhibition of pancreatic bicarbonate secretion, (e) reduction in mucosal blood flow, and (f) inhibition of mucosal prostaglandin production. Because these effects are related directly to the act of smoking and cessation of smoking is associated with the prompt recovery of the respective functions, smokers will benefit immediately by stopping or reducing cigarette consumption.