S230 Smoking Cessation in Chronic Pancreatitis: Real-World Treatment Utilization and Missed Opportunities

Introduction: Smoking is associated with accelerated progression of chronic pancreatitis (CP) and increased risk of pancreatic malignancy. While smoking cessation is a key component of CP management, the extent to which cessation therapies are utilized in routine clinical practice remains poorly studied. Our objective for this study was to evaluate the prevalence of active smoking and utilization of evidence-based smoking cessation interventions among patients with CP using a multicenter electronic health record (EHR) database. Methods: We conducted a retrospective observational cohort study utilizing the TriNetX U.S. Collaborative Network, a federated EHR database comprising data from multiple healthcare organizations. Adult patients (aged ≥18 years) with a primary or secondary diagnosis of CP, as defined by ICD-9/10 codes, and at least 1 ambulatory encounter between January 1, 2014, and January 1, 2024, were included. Active smoking status and the receipt of smoking cessation therapies i.e. nicotine replacement therapy (NRT), varenicline, bupropion, and behavioral counseling were extracted from structured EHR fields. Descriptive analyses were performed to quantify therapy utilization rates. The study adhered to the STROBE and RECORD reporting guidelines. Results: Among 149,210 CP patients identified over the 10-year period, 33,450 (22.4%) were classified as active smokers. Of these, 11,728 (33.1%) received NRT alone, 4,375 (13.1%) received NRT in combination with behavioral counseling, 1,762 (5.3%) were prescribed varenicline, and 3,404 (10.2%) received bupropion, with or without behavioral support. Conclusion: Despite strong evidence and clinical guideline recommendations, the use of smoking cessation therapies among CP patients remains suboptimal. Prior implementation efforts have shown limited success in this population, underscoring the need for targeted, systems-level strategies to improve cessation treatment delivery. These findings highlight a significant care gap and support the development of integrated interventions to enhance cessation support in CP management.