Does Tobacco Smoking Help Digestion?

The short answer is: no. Tobacco smoking does not help you get better digestion. In fact, it might do just the opposite of that.

Smoking can be detrimental to your overall health, and not only your lungs can be affected, but also other organs and systems in your body, including your digestive system. (1)

So, before we explain the effects of tobacco smoking on digestion, let us look at the organs that comprise the digestive system.

The Digestive System

The digestive system is a complex, intertwined structure comprised of the gastrointestinal tract, liver, gallbladder, and pancreas. The gastrointestinal tract is formed by a long “pipe” that starts in the mouth, goes through the esophagus, stomach, small intestine, and large intestine, and ends up in the anus.

Food enters the mouth, and enzymes are released to break down all the nutrients while one chews on it. After swallowing the food, it passes through the esophagus and towards the stomach, where more enzymes are released, and the natural-occurring acidic environment helps break it down even further.

Then, the partially-digested food enters the small intestine, where most nutrients are absorbed thanks to enzymes and digestive juices released by the pancreas, liver, and gallbladder.

Lastly, the mostly-digested food reaches the large intestine, where bacteria help break down the remaining nutrients. The waste products get mixed with water to form the fecal matter (stool) that is later released through the anus.

How Is Digestion Affected By Tobacco Smoking?

Now that you have the big picture of how the digestive system works, it is time to discuss how smoking can affect digestion.

Smoking can impair the digestion process in several ways:

Does Tobacco Smoking Help Digestion – Is Digestion Affected By Tobacco Smoking

It can produce or worsen heartburn.
It can cause stomach ulcers or compromise their healing.
It increases the risk of Crohn’s disease and its complications.
It increases the risk of pancreatitis, gallbladder conditions, and diverticular disease.
It is linked to a greater risk for many types of cancers.

Keep reading to learn how tobacco smoking contributes to each of these health problems.

Heartburn

Heartburn is described as a painful and/or burning feeling in the chest, and it is caused by acid reflux (when the stomach contents flow back into the esophagus). Therefore, it happens more frequently after eating or when lying down.

Under normal conditions, the food goes from your mouth to your esophagus and into your stomach. Once in the stomach, the food stays there thanks to a muscle called the lower esophageal sphincter (LES), which prevents the stomach contents from flowing back up to the esophagus.

However, smoking weakens the LES, and because of this, reflux happens. When the contents of the stomach -which are very acidic by nature- go back up, damage to the esophagus lining may occur. (2)

When a person has persistent heartburn symptoms more than two times per week, it is called gastroesophageal reflux disease (GERD).

Untreated GERD can eventually lead to: (3)

Long-term inflammation of the esophagus (esophagitis);
Bleeding ulcers in the esophagus;
Narrowing of the esophagus;
Barrett’s esophagus (pre-cancerous changes);
Esophageal cancer.

Peptic Ulcers

Peptic ulcers are sores occurring in the stomach and/or duodenum (the first portion of the small intestine). The main risk factors for peptic ulcers are prolonged use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac and infection by a bacterium called Helicobacter pylori. (4)

Smoking appears to contribute to the development of peptic ulcers by the following mechanisms:

Increasing the susceptibility to stomach-lining damage in people with Helicobacter pylori infection;
Increasing the secretion of gastric acid, thus creating a more acidic environment. (5, 6)

Additionally, smoking decreases the natural factors that protect the lining of the stomach and intestines in the following ways: (7, 8)

Disrupting the secretion of protective mucus.
Reducing the blood flow to the healing ulcer.
Slowing the healing of existing ulcers.

Furthermore, the risk of complications -especially of peptic ulcer perforation- increases in people who smoke compared to nonsmokers. (9)

Inflammatory Bowel Disease

Inflammatory bowel disease comprises ulcerative colitis and Crohn’s disease. Even though both conditions are very similar and cause swelling of the gastrointestinal tract, diarrhea, abdominal pain, and bloody stools, some differences can be identified among them:

Crohn’s Disease

Crohn’s disease can affect any part of the gastrointestinal tract, and its symptoms can vary in frequency and intensity from person to person.

People who smoke are more likely to have Crohn’s disease and develop disease-related complications. Additionally, people with Crohn’s who smoke have more frequent and severe symptoms and poorly respond to medical treatment. (10)

The good news is that the effects of smoking are temporary, and the course of the disease improves after smoking cessation. (11)

Ulcerative Colitis

Ulcerative colitis is a disease that affects the colon and rectum, part of the large intestine.

Interestingly, people who smoke have a lower risk of developing ulcerative colitis, and people with the disease who smoke are prone to milder symptoms. (10, 12, 13).

The protective effect of smoking against ulcerative colitis seems to come from nicotine or its metabolites, such as cotinine. Therefore, nicotine has been used to manage the symptoms of ulcerative colitis in selected cases, and its administration has been done under strict medical supervision using transdermal patches, chewing gum, or even enemas. (14)

Despite this, due to the harmful effects of smoking on almost all body systems, doctors don’t recommend smoking under any circumstances but instead encourage smoking cessation.

Pancreatitis

The pancreas is an organ located in the abdomen, behind the stomach. It has two main functions:

Releasing hormones that regulate blood sugar (glucose) levels: Insulin and glucagon.
Releasing digestive enzymes to help the gastrointestinal tract process foods.

Pancreatitis is the inflammation of the pancreas, which impairs the pancreas’ ability to function correctly. The leading causes are gallstones and heavy drinking. (15) However, in people who smoke, the risk of both acute (sudden) and chronic (long-term) pancreatitis is also increased. (16)

When acute, pancreatitis usually resolves within several days of rest, appropriate nutrition, and medical support. However, it can be life-threatening in severe cases. Common symptoms of acute pancreatitis include:

Severe stomach pain;
Nausea;
Vomiting;
Fever.

While in cases of chronic pancreatitis, the inflammation is long-term, leading to permanent organ scarring (fibrosis) and subsequent dysfunction. Symptoms of chronic pancreatitis include:

Intermittent stomach pain;
Digestive issues;
Inability to absorb some nutrients;
Weight loss;
Fatty stools.

Furthermore, chronic pancreatitis can lead to diabetes mellitus and also increases the risk of pancreatic cancer. (17)

Diverticular Disease

Some people may develop diverticula as they get older. Diverticula are small pockets in the inner walls of the colon.

According to the accompanying symptoms, it can be classified as: (18)

Diverticulosis

No symptoms

It is usually diagnosed by accident during testing for other reasons.

Diverticular disease

Mild symptoms

Symptoms may include:

Abdominal pain that gets better after defecating or releasing gas
Constipation
Diarrhea
Occasional bloody stools

Diverticulitis (inflamed or infected diverticula)

Severe symptoms

Symptoms are severe and may include:

Constant abdominal pain
Fever
Bloody stools
Bleeding from the anus

Although there are several risk factors for developing diverticular disease, it has been demonstrated that smoking increases the risk for diverticular disease and diverticulitis. (19)

Gallbladder Disease

The gallbladder is a pouch located under the liver, on the right upper side of the abdomen, just below the rib cage. Its main function is to store the bile produced by the liver, which then releases into the small intestine to aid with the digestion of fatty foods.

People who smoke have a greater risk of developing gallbladder disease, including: (20)

Inflammation of the gallbladder (cholecystitis);
Infection of the gallbladder;
Gallstones;
Tumors of the gallbladder.

Cancer

As previously discussed, smoking has been linked to numerous issues in most systems and organs in the body. In the digestive system, smoking can, directly and indirectly, increase the risk of the following types of cancer:

Esophageal Cancer

Since smoking increases the risk of GERD and, subsequently, Barrett’s esophagus, it can indirectly increase the risk of a subtype of esophageal cancer called adenocarcinoma. (21)

At the same time, smoking can also directly increase the risk of another subtype of esophageal cancer known as squamous cell carcinoma. (21)

Stomach Cancer

It has been found that people who smoke have a greater risk of developing stomach cancer when compared to nonsmokers. (22)

Liver Cancer

Smoking has been linked to an increased risk of hepatocellular carcinoma, especially in individuals affected by chronic hepatitis B and/or hepatitis C virus. (23)

Pancreatic Cancer

The risk of pancreatic cancer is two times higher for smokers when compared with nonsmokers, and this risk increases the more time and more cigarettes a person has smoked. (24)

Colorectal Cancer

Smoking induces damage to the intestines and changes in the gut microbiota, thus increasing the risk of colorectal cancer. This risk remains high for up to 25 years after smoking cessation. (25, 26)

Does Vaping Also Affect Digestion?

Yes, vaping also has a negative effect on your digestive system.

Electronic cigarettes, also known as E-cigarettes, have numerous liquid compounds that form an aerosol when heated. Some of the common substances that can be found in these devices include nicotine, vegetable glycerin, propylene glycol, and flavorings, among other ingredients. (27)

In animal models, vaping produced a set of adverse effects in the gastrointestinal tract:

Inflammation;
Gut microbiota imbalance;
Disruption of the normal intestinal barrier. (28)

Also, vaping can lead to several gastrointestinal symptoms in humans, such as: (29)

Xerostomia (dry mouth);
Nausea;
Vomiting;
Heartburn;
Constipation.

However, more studies are necessary to confirm whether vaping has the same effects as cigarette smoking in the gastrointestinal tract.

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Krystie Linares, MD

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Krystie Linares is a physician with 10 years of experience as a family practitioner and occupational health specialist. She has collaborated with several companies, startups, and individuals, by doing research, developing educational content, managing medical libraries, and working as a database curator.

Franco Cuevas, MD