van der Sloot KWJ, Tiems JL, Visschedijk MC, et al. - Researchers conducted this retrospective cohort study to explore the connection between colorectal neoplasia (CRN) development and active and passive cigarette smoke exposure in a inflammatory bowel disease (IBD) population. They screened 1,386 IBD patients with previous biopsies analyzed and reported in the PALGA register for development of CRN. Clinical factors and cigarette smoke were assessed. There were 153 (11.5%) patients who developed CRN. They replicated risk factors previously described, ie, the first-degree family member with CRN in Crohn disease (CD), postinflammatory polyp presence in ulcerative colitis (UC). While passive smoke exposure had no impact, former smoking increased the risk of CRN in UC. Active smoking and passive smoke exposure significantly increased CRN risk in patients with CD. This research is the first to explain cigarette smoke's important role in the development of CRN in patients with IBD. The current risk stratification for CRN surveillance strategies is strengthened by the inclusion of this risk factor.