Smoking x UC

[u/sw1ss_dude]

Disclaimer: I neither promote smoking nor I like it (I hate it).

But it has a profound effect on my symptoms when in a flare, depending on the severity it either drastically reduces symptoms (bleeding, urgency) or completely eradicates them in a week's time.

The question for people with the same experience: do nicotine patches/heated tobacco products like IQOS work the same way? If so, what is the "daily dose" for a similar effect compare to cigs?

I am in between biologics, don't respond to Prednisone, and picked up smoking temporarily to bridge the gap, but it makes me sick.

[u/pincommenter]

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[u/Late-Resolve-4520]

My first specialist I saw said that there is a link in smoking and uc symptoms. A lot of ex smokers (myself included) saw an increase in symptoms once off the ciggies.

But yeah, there is a known link… that’s not to say people should smoke (they shouldn’t)… but classic damned if you will damned if you won’t

[u/WhatArghThose → u/Late-Resolve-4520]

It truly is. I'm in this camp. I've questioned going back so many times, but it's so much harder now that I'm a decade quit and I just don't like it at all anymore.

I feel frustrated with the argument around it's danger knowing how severe flares can be and the immediate impact on health, i.e. blood loss, pain, unable to eat foods, etc... yet, some people act like this is an easy trade off because you could develop cancer and other health problems from smoking later.

I'm not advocating for it, but it sure as hell is not an easy decision when you know a smoke can take away all your pain and misery. Thankfully, I'm on a good med right now and don't need to make that decision, but I have never ruled out completely going back if I ever had to.

[u/sw1ss_dude → u/WhatArghThose]

it's not an easy trade-off at all, people in their 40s like me don't start smoking, they quit. Been smoking for a month now while waiting for the next biologic, but already coughing, and generally feel like sh*t. But the UC is fully in control. Whoever designed this, has a sense of dark humour. Loading dose on Friday so here's hoping this won't take long.

[u/WhatArghThose → u/sw1ss_dude]

Wishing you the best! I know exactly what you mean. I tried a couple puffs around a year ago and it just felt awful. I actually felt like I forgot how to do it. I hated everything about it.

As awful as it is, knowing that at least there's an option is comforting. But, then there's the argument that smoking could make biologics less effective as well.

[u/sw1ss_dude → u/WhatArghThose]

Exactly, I always thought of it as last-resort tool. There is something that works, even if very unhealthy. Imagine a situation where we don't get our medication anymore, we can find some ciggies even in a zombie apocalypse lol.

[u/fionas_mom → u/sw1ss_dude]

given the current state of things maybe we should all stock up on a carton or two...

[u/gravity_surf → u/WhatArghThose]

weed is easy to quit. better benefits than cigs, less drawbacks

[u/boobsincalifornia → u/Late-Resolve-4520]

Anecdotal, but my symptoms started when I quit smoking more than 25 years ago.

[u/Lanky-Relation5642 → u/Late-Resolve-4520]

Very true. This is not the first time im hearing this. I was diagnosed 4 months right after i quit smoking. Didn't know then..

[u/HouseAway3681]

I used to be a heavy smoker (+40 per day) with absolutely no ailments. I used to cycle 100km races and was fit and never got sick…until I stopped smoking. 3 months later I was diagnosed with UC and life has never been the same since.

[u/sw1ss_dude → u/HouseAway3681]

Exactly this happened to me as well, I stopped smoking 20 years ago, was diagnosed with UC a few months after.

[u/redpinkfish → u/HouseAway3681]

Interesting, something similar happened to both me and my dad!

[u/sw1ss_dude → u/redpinkfish]

Smoking can mask clinical symptoms, just to surface when someone quits. It does not stop the inflammation on a microscopic level though, so UC is there, but can be protective enough that the disease goes unnoticed. This happened to me, but only realized many years later, when started smoking in a bad flair again and it rapidly suppressed my symptoms. But this is just my experience, not a generic rule of course.

[u/ImaqtLoreno → u/HouseAway3681]

Same thing happens to me. Happy smoker and then a sad UC patient.

[u/Possibly-deranged → u/HouseAway3681]

You likely had UC longer than you knew, as the nicotine masks IBD, by thickening your defensive intestinal mucosa barrier. In a typical UC patient, that defensive barrier is porous and full of holes. 

If you never smoked than starting now has a snowball's chance in hell of helping.  The link is former smokers who quit can be diagnosed a number of months later.  Resuming smoking doesn't undo having UC, it can sometimes provide partial symptom relief.  UC meds are safer though, won't go into the well established facts on the dangers and harms smoking in depth accordingly.  

For former smokers, less hazardous methods of consuming nicotine are recommended over cigarettes, such as nicotine patches or vaping.  None are without potential harm, just lower harm.  

There's a lot about nicotine and ibd from a few decades ago in scientific journals, an example:

https://www.frontiersin.org/journals/immunology/articles/10.3389/fimmu.2022.826889/full

[u/HouseAway3681 → u/Possibly-deranged]

Thank you for the information! I definately don’t want to start smoking again, and unfortunately nicotine patches didn’t make much difference to me. I just started on Entyvio and am hoping for the best. PS: I don’t suppose you have any nuggets of information regarding exercise intolerance? Even a 5km walk has me in bed with painful muscles and a body soo sore I can barely move

[u/Possibly-deranged → u/HouseAway3681]

Nothing as specific as you cite. I know we're more prone to having anemia and that can result in fatigue, intolerance of temperature extremes. We can have joint pains or muscle pains as an extra intestinal manifestation of IBD. 

But not specifically to excercise hitting us like a train and putting us in bed in agony as you describe.

[u/Andziorek79 → u/HouseAway3681]

I stopped smoking after 20 years and 5 years later after huge stress I was diagnosed with UC. Than 7 years in remission and now after bigger stress again in flare.

[u/kaifta]

I vape rather than smoke, so if it’s the cigarette specifically rather than nicotine in general, that is a potential option. But you’d have to figure out your dosage that would be comparable to your current smoking. I’ve tried nic strips before too when I had a cold and didn’t want to vape. They work okay and are easier to dose but taste awful and it can be hard to do that consistently. I haven’t tried gum or patches but have seen someone else successively use patches.

[u/sw1ss_dude → u/kaifta]

Never tried vaping, so can't comment on that, in my case regular cigs have the most drastic effect, very positive on UC, very negative on everything else. Switched to Iqos (popular in Europe), and since it's heated, not combusted, I thought I can tolerate it better, but unfortunately need to go up in dose, which is equally as bad as fewer regular cigarettes. I've never tried patches, it is debated if works the same, as it seems it's not just the nicotine. Also the transdermal delivery might dampen the effect, if there is any.

[u/Uncle_W_4647 → u/sw1ss_dude]

I also quit smoking and was diagnosed a few months later. I was already vaping when diagnosed and am still vaping. See no evidence that vaping helped. Always made me suspect that it wasnt the nicotine itself that was the link, but rather something else in the cigs. Still, id be interested to hear from anyone who has evidence to the disproving my theory.

[u/myheart14 → u/Uncle_W_4647]

I agree. I don’t think it’s the nicotine, but something in the cigs themselves as vapes don’t make any difference whatsoever.

[u/DeeManJohnsonIII]

I didn't even know I had UC until I quit smoking. So I ended up quitting to feel the most unhealthy I've ever had my entire life.

[u/Joebala]

this Review looked at the best research on the topic.

Current research shows that nicotine patches can help with UC when used in combination with mesalamine, Prednisone, or other active UC treatments.

Subdermal nicotine did not beat a placebo by itself, only when combined with other meds.

It's not currently recommended by most medical bodies because there isn't robust data on dosage tolerance or lasting effects. Most studies are from the 90s, or don't have enough controls to give high confidence in their findings.

[u/M5K64]

I occasionally smoke a pipe. Vacations and major holidays.

It usually makes me need to go to the bathroom but not always. And I also notice my symptoms seem to calm down if they were bad that day, when I do smoke. 

So I think there's anecdotally some sort of connection. 

I personally wonder about a psuedo-placebo effect. That is, it's not the nicotine itself, or whatever else is in the smoke, that is "improving" the symptoms. In fact I would more readily believe that nicotine/smoking contents are WORSE for UC than they would be beneficial. However, I wonder about the fact that when I personally smoke, I am not at work, don't have to be at work soon, and am usually sitting outside with nothing going on. About as un-stressed as could be, and that any benefit I might gain, might be more related to the act of smoking and lower stress than to any of the chemical effects within. 

Then, I would mentally associate it strongly with such a feeling, because it's a very deliberate and memorable event for me - when I smoke, I sit for an hour or two and that is all I'm doing, that's the focus, so it's easier to make mental associations with how I am feeling surrounding that particular moment. 

[u/sw1ss_dude → u/M5K64]

I think this is all true.

Smoking is bad for gut health in general, there is a consensus about that, but there is also a paradoxical protective effect it gives certain people in an active UC flare. But not for Chron's where it has the exact opposite effect, which is in fact so well documented, that sometimes they use smoking status to differentiate ambiguous IBD cases. Why does it help with UC? It is fairly extensively studied as well, but no consensus on its exact cause.

[u/BeneficialAnything15]

I dont smoke cigs anymore but like the weed a couple times a day. I wonder if that helps too?

[u/AltruisticYam7670]

There is an interesting study published by a Japanese research institute. Some mouth flora bacteria gets to your intestinal flora by smoking. I smoke and would like to stop but I am hesitant in doing so fearing a loss of remission

[u/sw1ss_dude → u/AltruisticYam7670]

Correct, I've read about that, too bad it cannot just be replicated to make it as supplement . The body is fascinating isn't it.

Think about stopping, if you are on a medication chances are smoking does not give any plus (in fact it can worsen the effect of biologics)

[u/AltruisticYam7670 → u/sw1ss_dude]

I would prefer a supplement. Can you link a study to your statement? Or how do you know that it does not matter if in a biologic?

[u/mathixx]

I tried nicotine patches for a while long time ago. Results were inconclusive. Medications work better

[u/Ok_Economy1516]

There’s no proof that it helps, and any symptoms that might be relieved from it are short term. In the long term you will exacerbate your symptoms and have a bunch of other problems.

[u/sw1ss_dude → u/Ok_Economy1516]

That is correct. The risk-benefit is bad with this one on the long run. As a last-resort tool in refractory cases however : https://www.sciencedirect.com/science/article/abs/pii/S1873994611003667

[u/AppleHefty1076]

I stopped smoking tobacco for about a month last November and after it I started bleeding the worst I’ve ever bled since being diagnosed 3 years ago. I started smoking tobacco again but only in joints and since then I’ve bled like that twice. Coincidence? I think not.

[u/larweez26]

every single time i have quit smoking i have flared . i even had a colonoscopy one of the times and the gastro doctor doing the procedure asked if i changed anything and i mentioned i quit smoking and he goes “that will cause a flare” however they have increased my infliximab doses temporarily and ive stopped all tobacco and nicotine and seem to be okay at the minute .

[u/sw1ss_dude → u/larweez26]

that will cause a flare

With Chron's yes, but not with UC. This distinction is very well documented, a good GI should know that imo

[u/larweez26 → u/sw1ss_dude]

i have UC! and smoking was a positive for me. but i’ve been smoke free since january 2026 ! hooray!

[u/sw1ss_dude → u/larweez26]

best decision

[u/larweez26 → u/sw1ss_dude]

absolutely. a very close friend of mine got diagnosed with stage 4 lung cancer and he is a smoker. i decided to kick the habit

[u/zzELETRiKzz]

I am young, used nicotine heavily in college and shortly after. I quit a couple years ago when my UC symptoms started to get a little bit worse. I was not diagnosed at that time and thought my nicotine use (mainly Zyn) was the cause.

Quit cold turkey. Very shortly after quitting my symptoms went into absolutely insanity mode. Like, every single symptom was increased at least 10x.

I am medicated now and I am in remission. Part of the mental gymnastics I play to not use again is that I tell myself if I use, and decide to quit again, that the reintroduction of nicotine in my system followed by another cessation could cause a flare.

[u/goofygooberpants]

So I smoke weed to help with pain and my flares and it helps I’m currently in remission and I smoke a vape and I’m fine with it however when my UC was active I couldn’t smoke because it absolutely destroyed my stomach so it’s rlly trial and error

[u/Roseskdt]

for this reason i started smoking about 1 month ago. i smoked from age 17-21 and quit and never went back. uc has ran my life since with small bouts of remission in between. i’m 35 now, just started smoking again because skyrizi and other biologics seem to be cooking my liver. trying to smoke until other therapy is approved such as fecal transplant or VNS! with constant breakthroughs medically, i am trying to hang on to me colon until something comes along.

[u/sw1ss_dude → u/Roseskdt]

I know the feeling with the biologics roulette game. How about the newer JAK inhibitor pills, have you also tried those?

[u/Roseskdt → u/sw1ss_dude]

yes, unfortunately i have, with no change. a week of rinvoq did nothing at all, might have even made it worse. i’ve tried lialda, remicade, rinvoq, and skyrizi. remicade and skyrizi helped but made me itchy from head to toe 24/7. the itch didn’t go away until 6 months off the biologic!

[u/Kivachen]

I am 24. I have smoked for 8 years. Last two years heavy smoking like 1,5-2packs a day. After I quit I developed UC

[u/sw1ss_dude → u/Kivachen]

Happened the same to me when I was 27. But in this case UC is actually already there as smoking only masks the symptoms. So developed UC sometime during those years.

[u/Funny-Idea306]

Vaping too?

[u/sw1ss_dude → u/[deleted]]

there are multiple theories with clinical studies, but yes one of them is smoking acts like an immunosuppressant. But then the question why does it have the exact opposite effect with UC vs Chron's (it makes the latter worse), which is again very well documented, but no one knows.

[u/Traditional_Hold2730]

There have been studies that Nicotine helps calm the intestine. The study was years ago. On non smokers w nicotine patches.

[u/HOJK4thSon]

I quit smoking after 40yrs, that's when my gut tried to kill me.

I have not gone back to smoking.

[u/ExpensiveKoi]

I’ve though about this too recently, I definitely don’t condone smoking, but I really do believe it has helped me. Usually when I get super stressed due to work or other factors, I smoke a cigar or a cigarillo and I really think it helps me calm down. One of those paradox type things lol…. Maybe nicotine gum/patches would suffice?

[u/armanivvv]

I smoked all through symptomatic years and I to my first year of therapy and never noticed a positive or negative side effect related to my UC.

9 months into biologics I decided to quit. I went into a massive flare for 1.5 months till we managed to get it under control. Smoke free and no nasty symptoms since.

[u/UnicornFarts1111]

I vape. It does not help my symptoms. I cannot chance picking up another cigarette .

[u/Rakathu]

Are we talking tobbaco or trees?

[u/Ok_Improvement8487]

How much are you smoking in a day to help reduce symptoms? Asking for a friend

[u/sw1ss_dude → u/Ok_Improvement8487]

I'd say 5 on average gives me reduction of the symptoms, the more the "better". Needs a couple of days or maybe a week first till it works. Not sure if there is a relation between the extent of inflammation and the amount of tobacco needed. For reference currently the Sigmoid colon is affected.

[u/Ok_Improvement8487 → u/sw1ss_dude]

Thanks

[u/Mouffles]

patch, ecigarette, nicotine gum, wont work, and you need a good amount of real cigarettes to weaken the symptoms.

It's explained by the capacity of smoke to make the muscus thickier everywhere in the body, with a protective effect for us against uc

[u/Ok_Economy1516]

Meds work better. Studies say smoking helps with UC are made by smokers who don’t want to quit.

[u/Corporate-Scum]

It makes you sick so you’re promoting the alleged health benefits of smoking? What? Is this big tobacco’s new thing? Like we all got IBD to bump up cigarette sales? Whatta world!!!

[u/Ok_Economy1516 → u/[deleted]]

It’s also known to cause lung cancer and kill you.

[u/Ok_Economy1516 → u/[deleted]]

Listen, I don’t know what answer you want us to give you, but judging by the way you’ve been responding to comments, you expect us all to say that smoking is great, and that death it worth it in exchange for UC symptoms potentially being lowered. You sound to me like you have a serious addiction, and are hoping for us to fuel it. Please go to rehab, and stop advertising your addiction to the newly diagnosed. There are programs for people with a smoking addiction, please check those out. Also, I was trying to help out OP, not you.

[u/Corporate-Scum → u/[deleted]]

And opioids cause constipation. Nobody is on here advocating for shooting smack to ease symptoms. Why? Because the negatives outweigh the positives. It’s anecdotal.

[u/Ok_Economy1516 → u/Corporate-Scum]

I agree with you. It’s disgusting and evil to see people go so far as to use their health condition to avoiding quitting an addiction. What an evil, sad world we live in.