Smoking and RA: A Deadly Combination

According to the results of a study published in Arthritis Care & Research, British researchers reported that death rates were more than doubled in smokers with rheumatoid arthritis (RA) compared with those who have never smoked, and that the mortality risk fell significantly each year after quitting.

In general, patients with RA have a mortality risk about one and a half times that of the general population. RA patients also have higher rates of smoking and other cardiovascular risk factors. In fact, people with RA have almost twice the risk of heart-disease as their same-age peers. RA-related inflammation affecting the arteries is thought to be the reason. Rheumatoid arthritis is considered to be a risk factor for the development of heart disease, and of equal importance to other known risks including diabetes, high blood pressure, elevated cholesterol, smoking, and family history. For this reason, individuals with RA should make an extra effort to eat heart-healthy food, exercise regularly, and avoid smoking.

To study the impact of smoking, researchers evaluated patient records form 5,677 patients with RA from the Clinical Practice Research Datalink (CPRD), a U.K. database of primary care electronic medical records. Overall, individuals with RA were followed for an average duration of 4.7 years. During this time 16% changed smoking status, including 348 current smokers who stopped smoking after a single attempt.

After adjustment for age and sex, the mortality rates for never, former, and current smokers were 16.2, 22.4, and 31.6 per 1,000 person-years, respectively. This translates into about 6 deaths per 1,000 person-years attributable to former smoking, and 15 deaths per 1,000 person-years attributable to current smoking. Key causes of death in smokers were cardiovascular and circulatory diseases and lung cancer.

The results of this study emphasize that smoking cessation programs may be even be more relevant for patients newly diagnosed with RA and smoking cessation should be a priority.

Reference:  Joseph RM, Movahedi M, Dixon W, et al. Smoking-related mortality in patients with early rheumatoid arthritis – a retrospective cohort study using the Clinical Practice Research Datalink. Accessed March 28, 2016. Abstract. DOI: 10.1002/acr.22882.