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Only a small minority of alcoholics develop clinical evidence of pancreatitis. The reasons for this variation in individual susceptibility have not yet been defined. Recent studies have suggested that smoking may be a risk factor for the development of pancreatitis. However, there have been methodological problems with these studies regarding choice of controls and assessment of tobacco consumption. The present study was designed to determine whether smoking is a risk factor for pancreatitis in alcoholics. Tobacco consumption in alcoholics with pancreatitis was compared to that of alcoholics without pancreatitis (controls). Of 52 subjects with alcoholic pancreatitis, 86.5% were smokers compared with 87.2% of 47 alcoholic controls. Both daily and lifetime tobacco consumption in subjects with pancreatitis were less than those of alcoholic controls. Thus, there was no association between smoking and pancreatitis in this study. The previously described association between smoking and pancreatitis may be related to the high prevalence of smoking among alcoholics.