Relation of smoking and alcohol and coffee consumption to active Helicobacter pylori infection: cross sectional study

Objective: To assess the relation of smoking and alcohol and coffee consumption to active Helicobacter pylori infection. Design: Cross sectional study of patients attending a general practitioner Active H pylori infection was measured by the C-13-urea breath test and detailed quantitative information on smoking and on alcohol and coffee consumption was obtained by a standardised self administered questionnaire. Setting: One general practice in Germany. Subjects: 447 patients aged 15-79 who had not had peptic ulcer disease or treatment for H pylori infection. Main outcome measures: Prevalence of H pylori infection according to smoking and alcohol and coffee consumption. Results: Overall prevalence of infection was 21% (94/447). There was no significant relation between smoking and active H pylori infection. Alcohol consumption showed a negative dose-response relation and coffee consumption a positive dose-response relation with active infection. After adjustment for potential confounders, the odds ratios for patients who drank less than or equal to 75 g and >75 g of ethanol a week compared with non-drinkers were 0.90 (95% confidence interval 0.55 to 1.59) and 0.33 (0.16 to 0.68), respectively (P value for trend 0.005, assuming that 1 litre of beer and 0.5 l of nine contain on average 50 g of ethanol in south Germany). Adjusted odds ratios for patients who drank <3 cups and greater than or equal to 3 cups of coffee per day compared with those who did not drink coffee were 1.49 (0.71 to 3.12) and 2.49 (1.23 to 5.03), respectively (P value for trend 0.007). Conclusion: These results suggest a protective effect of alcohol consumption against active infection with H pyolri and an opposite effect of coffee consumption.