Cigarette smoking and duodenal coating with barium.

A review of two hundred and fifty-eight double contrast barium meal examinations was carried out in a single blind study of the relationship between smoking and the ability to visualize gastric and duodenal mucosal detail. A strong correlation was found between poor duodenal visualization and smoking in the period immediately prior to the examination. Patient compliance with a typed instruction sheet forbidding smoking was found to be poor. It may be possible to improve compliance by including, in the written instructions, an explicit statement that smoking shortly before barium meal examination may cause lesions to be missed.