Yes, smoking is linked to the development of rheumatoid arthritis, particularly for people who have smoked 20 years or longer.
Smokers also have an increased risk of more-severe rheumatoid arthritis. In addition, they may be less likely to experience remission.
Smoking decreases the effectiveness of some drugs used to treat rheumatoid arthritis and can be a barrier to engaging in activities that may relieve symptoms of rheumatoid arthritis, such as exercise.
The exact reason why smoking is linked to rheumatoid arthritis isn't well understood, but researchers suspect smoking somehow ignites faulty immune system functioning in people genetically predisposed to getting rheumatoid arthritis.
Cigarette smoking increases the risk of developing rheumatoid arthritis-associated interstitial lung disease.
Both environmental and genetic factors play a role in who gets rheumatoid arthritis, and smoking is considered one of the most important environmental risk factors. But it's a risk factor that's completely preventable.
Many people with rheumatoid arthritis aren't aware that smoking makes their condition worse, so they don't see it as a reason to quit. Plus, there are factors unique to rheumatoid arthritis that may make it more challenging to quit smoking. These factors include the idea that smoking is a distraction that helps people cope with the pain of rheumatoid arthritis and feelings of isolation and lack of support.
But quitting smoking is important for your overall health too. Along with increasing rheumatoid arthritis risks, smoking also ups your odds of:
- Lung and other cancers
- Respiratory disease
- Cardiovascular disease
If you have rheumatoid arthritis and smoke, quitting could have numerous benefits. Talk to your doctor about strategies to help you quit.
March 26, 2020
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- Svendsen AJ, et al. Incidence of chronic persistent rheumatoid arthritis and the impact of smoking: A historical twin cohort study. Arthritis Care & Research. 2017; doi:10.1002/acr.22987.
- Rich RR, et al. Rheumatoid arthritis. In: Clinical Immunology: Principles and Practice. 5th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Jan. 27, 2020.
- Hochberg, MC, et al. Classification and epidemiology of rheumatoid arthritis. In: Rheumatology. 7th ed. Elsevier; 2019. https://www.clinicalkey.com. Accessed Jan. 27, 2020.
- Rheumatoid arthritis. Centers for Disease Control and Prevention. https://www.cdc.gov/arthritis/basics/rheumatoid-arthritis.html. Accessed March 8, 2020.
- Wattiaux A, et al. Patient perspectives on smoking cessation and interventions in rheumatology clinics. Arthritis Care & Research. 2020; doi:10.1002/acr.23858.
- Perricone C, et al. Smoke and autoimmunity: The fire behind the disease. Autoimmunity Reviews. 2016; doi:10.1016/j.autrev.2016.01.001.
- England BR. Epidemiology of, risk factors for, and possible causes of rheumatoid arthritis. https://www.uptodate.com/contents/search. Accessed March 9, 2020.
- AskMayoExpert. Inflammatory arthritis rehabilitation. Mayo Clinic; 2019.
- AskMayoExpert. Tobacco use (adult). Mayo Clinic; 2019.
- Health effects of cigarette smoking. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm. Accessed March 8, 2020.
- Lake FR. Interstitial lung disease in rheumatoid arthritis. https://www.uptodate.com/contents/search. Accessed March 10, 2020.