Rheumatoid Arthritis? Stop Smoking!

It has been known for some time that an association exists between smoking and rheumatoid arthritis (RA). However, research has been lacking on the possible ways in which smoking might affect RA flares and remission.

In a new study presented at the annual meeting of the American College of Rheumatology, researchers introduced evidence that smoking adversely affects flares and remissions in RA. The scientists examined the medical records of 650 adults with RA for evidence of flares and remission events. They looked especially at the reasons RA patients made clinical visits.

The researchers, led by Shafay Raheel, MD, of the Mayo Clinic, in Rochester, Minnesota, discovered that active smokers had significantly more visits for flare-ups than nonsmokers did. However, RA patients who had smoked but had since quit were no different from patients who had never smoked. The evidence also suggested that in the early stages of the disease, smokers and nonsmokers had similar rates of disease flares, but that over time, the smokers began to have more flares. As for remission, it was found that remission rates were higher for nonsmokers than for smokers. Again, there was little difference between those who had never smoked and those who had quit.

Because the study results were presented to medical professionals, the researchers emphasized how important it is for physicians to counsel their patients on the importance of quitting smoking. Their findings, they said, can give physicians the evidence they need to inspire their patients to work on behavior modification. One strong point that can encourage patients is that smokers with RA who quit appear to reach the same flare/remission status as patients who never smoked.

Another new study, published in May in the journal Arthritis Care and Research, showed higher death rates for RA patients who smoke. Jeffrey A. Sparks, MD, of the Brigham and Women’s Hospital in Boston, reviewed the medical histories of more than 120,000 women who were tracked by the Nurses’ Health Study from 1976 to 2012.

Women who stopped smoking four years before an RA diagnosis had a reduced mortality risk compared to participants who continued smoking, Sparks reported.

Want to learn more about rheumatoid arthritis? Read “Steps to Manage Rheumatoid Arthritis Flare-Ups” and “Managing Sleep Problems in RA.”

Joseph Gustaitis is a freelance writer and editor based in the Chicago area.

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