Chronic Hepatitis B & C – Blessing in Disguise for Alcoholics and Smokers

Introduction: Alcohol and tobacco intake are closely linked habits, often increasing risks for cancers and other diseases, and many studies have shown high co-occurrence, especially in India, influenced by age, gender, education, and peer/family habits, with physician advice showing promise for cessation. The factors like peer pressure, stress, profession like drivers and army, affect imbibing of habit of drinking alcohol and smoking. Many patients of hepatitis B and C are chronic smokers and alcoholics and are terrified when they come to know about their disease for the first time. Majority of them know that chronic hepatitis B & C can lead to liver damage and alcohol & smoking also effect liver. Thus, they are very receptive when they are newly diagnosed. This is the best time to get them abstained from it and same practice was followed with successful results. Aim of study: To determine the abstinence from alcohol intake and smoking in patients of chronic hepatitis B and C who reported in Department of Medical Gastroenterology, PGIMS, Rohtak. Materials & Methods: It was prospective study conducted at Department of Medical Gastroenterology, Post Graduate Institute of Medical Sciences (PGIMS), Rohtak, over a period of ten years from 1st December, 2015 to 30th November, 2025 during which 24000 patients of chronic hepatitis B and C who reported in Medical Gastroenterology OPD were interviewed for alcohol intake and smoking, at the time of enrolment. The patients who were in habit of taking alcohol or smoke were motivated to completely abstain from it. On every follow-up, they were re-confirmed for abstinence, both from patient themselves and accompanying family members. The findings were regularly recorded in their records. The details regarding at which age they started, under what circumstances this habit occurred, meaning by under pressure from friend circle or from family members, was also noted. Results: We enrolled total 24000 patients who reported to Department of Medical Gastroenterology for treatment of chronic hepatitis B and C. Out of these 24000 patients, 16000 (66.66%) were having chronic hepatitis C and 8000 (33.33%) were having chronic hepatitis B. In total pool of 16000 HCV patients, 10,400 (65%) were male and 5600 (35%) were female whereas among total 8000 HBV patients, 5040 (63%) were male and 2960 (37%) were female. The predominance was of rural background was seen in both HCV and HBV groups i.e. 10720 patients (67%) and 5120 patients (64%) respectively. Out of total 24000 patients, total 7680 (32%) were consuming alcohol. Out of these 7680 alcoholics, 2227 (28.99%) were only alcoholics and 5453 (71.01%) were in habit of smoking along with alcohol. On regular counselling, 6144 (80%) left alcohol but 1536 (20%) continued to drink alcohol. Out of total 24000 patients, total 11520 (48%) were smoker. Out of these 11520 smokers, 5760 (50%) were selectively smokers and 5760 (50%) were in habit of smoking along with alcohol. On regular counselling, 8064 (70%) left smoking but 3456 (30%) continued to smoke. The major chunk of patients who continued to smoke were hukkah smokers and belonged to rural background where hukkah smoking is issue of prestige and social bonding. Conclusion: Alcohol and smoking are risk factors for various diseases including malignancy. Smoking leads to increased viral replication in HCV and HBV and alcohol leads to detrimental effect on liver, reserve of which is compromised by various factors like chronic viral infections. In majority, the habit of drinking alcohol and smoking starts in young age due to pressure from friend circle. The proper counselling by treating physician, especially at time of diagnosis of hepatitis B and C is effective in developing abstinence in the smokers and drinkers. Keywords: Hepatitis B, Hepatitis C, Alcohol, Smoking, Rural, Urban, Male.