It is well-known that smoking is a major cause of lung cancer and cardiovascular disease, but you may not realize that it also plays a major role in the development and severity of many other diseases, including rheumatoid arthritis.
Some of the risk factors for RA are fixed, like female gender, family history and age. Other risk factors are the result of lifestyle choices and can be modified, including obesity, diet and smoking.
But not all of these risk factors are equal.
In fact, of the modifiable risks, smoking is the behavior that has the most effect on the development and severity of RA.
“More than any other factor, studies have shown that smoking is the most important risk factor by far,” says Dr. Kristen Demoruelle, a rheumatologist specializing in RA at the University of Colorado, Denver.
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A recent meta-analysis of several studies found that the risk of developing RA was approximately twice as high for heavy smokers and for men who had rheumatoid factor autoantibodies in their blood than for men who had never smoked. For female smokers, the same analysis found that the risk was approximately 1.3-times higher than for nonsmokers.
A study published in Arthritis Research and Therapy found that even light smoking is linked to an elevated risk of RA.
The study further found that quitting smoking decreased the likelihood of developing RA, and that the overall risk continued to drop with time, falling as much as one-third 15 years after stopping smoking. However, despite this decline in risk, the study found that former smokers still had a much higher risk of developing RA 15 years after quitting than people who never smoked.
The exact role that smoking plays in the development of RA is unknown. Researchers think that smoking causes the immune system to malfunction, especially in those who already have a genetic predisposition to developing RA.
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It is known that smoking causes damage in a variety of ways. It clearly promotes cell death, increases general inflammation, elicits the creation of antibodies to the body’s own tissues and causes epigenetic changes — modifications in gene expression and action.
It’s not surprising then that although the rate of cigarette smoking has continued to decline since the 1970s, it is still the leading cause of preventable death in the U.S. According to the Centers for Disease Control and Prevention, smoking is responsible for about 20 percent of all deaths in the U.S. each year.
Smoking is also known to cause oxidative stress by increasing the amount of free radicals that damage tissues throughout the body.
All of these factors can contribute to and exacerbate the inflammatory process that is already creating havoc in people with RA.
Smoking is not only a risk factor for people who have not yet developed RA. It also impacts the course of the disease in patients who have already been diagnosed with RA.
“Smoking can interfere with the RA medications and other treatments, making them less effective,” says Dr. Leonard Calabrese, a rheumatologist and immunologist at the Cleveland Clinic.
It also impacts the severity of the disease. “Smokers generally have more serious disease than nonsmokers,” he advises.
Research is clear that smoking is harmful to RA. Therefore, quitting smoking potentially will not only help your overall symptoms, it is likely to increase the efficacy of the RA medications you are already taking, and may even enable your doctor to reduce the dose of those medications.
Quitting smoking is difficult for anyone, and it may present a special problem for RA sufferers, who might find that lighting up a cigarette has a calming influence that can help them cope with RA’s symptoms.
However, the damage produced by smoking far outweighs any comfort it may provide, so it is essential that smokers with RA do everything possible to try to quit.
Fortunately, there are effective strategies for quitting that may reduce the trauma associated with stopping. See your rheumatologist, who can help develop an individualized plan to help you quit.
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And above all, never forget that RA is not your fault, says Dr. Roger Kornu, a rheumatologist with the University of California, Irvine. “You did nothing to bring on this disease,” he emphasizes.
But you can potentially make changes to try to minimize the effects of the disease, and stopping smoking is probably the most immediate step you can take that can produce significant benefits.
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Do I Risk Worsening My Rheumatoid Arthritis by Smoking? originally appeared on usnews.com
