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Morbidity and Mortality Weekly Report 65(42):1177

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Only 9% of Americans with a postgraduate education smoke cigarettes

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Results in Real Numbers Sphincter pressure reduction : 40% decrease in lower esophageal sphincter pressure in smokers Increased relaxation frequency : 3-fold increase in transient lower esophageal sphincter relaxations Impaired acid clearance : 50% longer esophageal acid clearance times in smokers Reduced saliva production : 30% decrease in saliva flow rate and bicarbonate content Increased reflux episodes : 2-3 times more reflux episodes per hour in smokers Symptom severity : 60% higher symptom scores in smoking GERD patients Safety, Limits, and Caveats The study examined acute and chronic effects of smoking but didnt extensively assess the reversibility of these mechanisms after smoking cessation