You never hear positive things about smoking, for obvious reasons: It dramatically increases your risk of lung and other forms of cancer. Smoking is linked to 30 percent of all deaths from cancer in the United States, and 80 percent of lung cancer deaths. It’s also a major contributor to heart disease. The list of negatives is long and the research is solid.

But there’s one, tiny check in the “pro” column for smoking: Cigarette smoking may have a protective effect on ulcerative colitis.

A study published in July 2015 in the journal Alimentary Pharmacology and Therapeutics reviewed health data on a group of patients with IBD and found that patients with UC who smoke needed less steroid medication compared with nonsmokers, and ex-smokers needed more steroid and immunosuppressive drugs. Although the study also noted that the smokers with UC had the same rate of colectomy (surgery to remove diseased portions of the colon) and hospital admissions as nonsmokers with the condition, an earlier study in The American Journal of Gastroenterology found that the heaviest smokers were the least likely to develop UC.

Why Might Smoking Have a Protective Effect on UC?

The key is probably the nicotine in cigarette smoke. According to Crohn's and Colitis UK, nicotine may suppress your immune system, decrease the inflammation of ulcerative colitis, and boost production of the mucus in the colon that acts as a protective barrier. Also, nitric oxide, a chemical released by nicotine, may help calm intestinal spasms that trigger the urge to have a bowel movement by reducing muscle activity in the colon.

All this is not to suggest that, if you’re a smoker, you should forget about quitting in a bid to stave off ulcerative colitis. And if you don’t smoke, it goes without saying that you should not consider taking it up. “I advise all my patients to quit smoking because of its multitude of adverse effects on the body,” says Matilda Hagan, MD, a gastroenterologist at The Center for Inflammatory Bowel and Colorectal diseases at Mercy Medical Center in Baltimore. She notes that there are effective treatments, including drugs and other therapies, that address ulcerative colitis. “It’s true that those medications can have side effects, but the negative effect of smoking long-term outweighs any negative effects of UC medications.”

Can Nicotine Patches or Gum Help?

If it's suspected that nicotine is a main driver in smoking’s protective effect against ulcerative colitis, it would stand to reason that you could potentially mimic that by using nicotine patches or gums, avoiding smoking altogether. But that doesn’t seem to be the case.

In a review published in October 2012 in Alimentary Pharmacology and Therapeutics, researchers stated that nicotine patch therapy in UC patients may have some positive therapeutic effects on ulcerative colitis even for nonsmokers, but the studies supporting this are limited and more research is needed. Still, the authors noted, its use as a treatment could be considered in acute cases of UC when patients are not responding to conventional treatments. It’s also important to remember that not everyone can tolerate nicotine and may experience side effects, including nausea, light-headedness and dizziness, tremor, headaches, and difficulty sleeping.

Clearly, no doctor is going to recommend you start or continue smoking as a treatment for ulcerative colitis. “Our aim will never be to promote smoking as a disease-controlling agent,” says Dr. Hagan. Speak to your doctor about other forms of treatment, including medication, dietary changes, or alternative therapies.