Preventing the Recurrence of Acute Pancreatitis by Alcohol and Smoking Cessation
Preventing the Recurrence of Acute Pancreatitis by Alcohol and Smoking Cessation
Recurrence of acute pancreatitis (AP) is often facilitated by regular alcohol consumption and
 smoking. An applied lifestyle intervention focusing on the cessation of alcohol consumption
 and smoking might prevent the recurrence of AP. REAPPEAR Study is a randomized controlled
 trial and a cohort study focusing on the efficacy of the lifestyle intervention and the
 effect of quitting alcohol and smoking respectively.
Alcohol and smoking caused recurrent acute pancretitis might be prevented. The condition is
 known for it's causative effect of chronic pancreatitis and nonbeneficial effect on quality
 of life. Clinical equipoise regarding the impact of alcohol and smoking cessation still
 exists, due to the non existence of well designed clinical trials. The aim of the REAPPEAR
 study is to investigate the effect of cessation program of alcohol and tobacco use on the
 recurrence of acute pancreatitis.

 The REAPPEAR Study is a combined clinical trial involving a randomized multicenter clinical
 trial (REAPPEAR-T), which assesses the effect of the cessation program on the recurrence of
 the acute pancreatitis, and a cohort analysis, which investigates the effect of smoking and
 alcohol cessation on the recurrance of acute pancreatitis. Daily smokers, hospitalized with
 alcohol-induced pancreatitis will be included in the trial. Standard cessational intervention
 will be provided for all patients before enrollment. Laboratory testing, measurement of blood
 pressure and BMI will be performed, while also hair, urine samples and blood will be
 retrieved for later biomarker measurement. The evaluation of motivation to change, addiction,
 quality of life and socioeconomic status will be recorded at every visit, which will take
 place every 3 months or yearly according to the random allocation. For patients, who present
 at visit of every 3 months a brief intervention will be provided, together with a laboratory
 testing to provide feedback. The primary composite endpoint of this study will be the
 recurrence rate of acute pancreatitis irrespective of etiology and all-cause mortality in a 2
 year timeframe. The cost-effectiveness will be also evaluated.
Inclusion Criteria:

 -  Patient hospitalized with alcohol-induced AP

 -  Regular consumption of at least 40g (women)/ 50g (men) alcohol daily or 280g (women)/
 350g (men) alcohol during the preceding week of onset of abdominal pain

 -  Every day smoker (an adult who has smoked at least 100 cigarettes in his or her
 lifetime, and who now smokes every day; CDC definition), with at least 1-year history
 of smoking

 -  individuals between 18-65 years of age

 -  completed the standard intervention

 -  provided written informed consent

 Exclusion Criteria:

 -  Other possible etiologies for AP (eg. gallstones, hypertriglyceridemia above 11.5 mM ,
 hypercalcemia, viral infection) and cases with more than one identified etiological
 factors will be excluded

 -  Major psychiatric illnesses (schizophrenia, bipolar disorder, dementia)

 -  currently receiving therapy for alcohol use disorder

 -  currently taking part in a smoking cessation program

 -  at least 3 documented episodes of AP or diagnosed chronic pancreatitis

 -  undergoing active or palliative treatment for malignancy

 -  pregnancy

 -  chronic pancreatitis

 -  life expectancy is less than two years