Objective To explore the correlation between smoking and Helicobacter pylori infection and provide evidence health promotion and management.

Methods Subjects aged ≥18 years who received health examination in Hebei General Hospital in 2023 were selected for the detection of H. pylori infection by ¹³C urea respiratory test, and the information about their demographic characteristics, such as age, gender and body weight, the lifestyle, such as smoking and drinking, and the indicators such as blood and liver functions were collected for the analysis on the correlation between smoking and H. pylori infection by t test, χ² test and multivariate logistic regression analysis.

Results A total of 23 817 subjects were selected,the prevalence of H. pylori infection was 33.30%. The prevalence of H. pylori infection was higher in men (58.79%) than in women (41.21%) (χ²=12.144, P<0.001), and the rates of smoking and alcohol consumption, overweight and obesity, height, weight, waist circumference, systolic blood pressure, diastolic blood pressure and the levels of creatinine, uric acid, fasting plasma glucose, total cholesterol, low-density lipoprotein cholesterol, triglyceride, γ-glutamyl transferase, and aspartate amino transferase were higher in the subjects with H. pylori infection than in the subjects without H. pylori infection, while the subjects with H. pylori infection had lower high-density lipoprotein cholesterol levels and rates of hypertension compared with those without H. pylori infection. There were no significant differences in age, urea nitrogen, alanine transferase and glycosylated hemoglobin A1c levels between the two groups (all P>0.05). All results of multivariate logistic regression analysis showed that the smoking group had a 0.13 higher risk for H. pylori infection compared with the non-smoking group (odds ratio=1.13; 95% confidence interval: 1.03–1.24, P=0.009).

Conclusion Smoking is a risk factor for H. pylori infection, and smoking control has clinical value in the prevention and control of H. pylori infection.