The role of alcohol and smoking in peptic ulceration has been investigated in many previous epidemiologic studies.[ 29 , 30 , 31 ] A positive association between smoking, alcohol, and increased risk of peptic ulceration, bleeding, and perforation has been reported in a population-based cohort study.[ 30 ] Decades ago, Smedley etal .[ 31 ] demonstrated highly significant positive association between smoking and duodenal ulcer perforation.
1
—
—