In patients with rheumatoid arthritis, smoking had a dramatic effect on mortality.
Smoking cessation leads to lower early mortality among patients with chronic obstructive pulmonary disease, diabetes, and coronary artery disease, but data are lacking on effects of smoking in patients with newly diagnosed rheumatoid arthritis (RA).
Researchers used data from 121,700 women in the Nurses' Health Study to see if smoking status affected mortality outcomes in patients with RA. A total of 938 women with incident RA were matched with 8951 non-RA controls; about 60% of women in both groups had ever smoked. Among RA patients, 40% of smokers quit permanently within 4 years of RA diagnosis; 36% of non-RA controls quit during the same period.
This study suggests that smoking has an additive detrimental effect in RA patients and is associated with twofold excess mortality risk compared with risk in a non-RA population. These findings will be very helpful in discussing smoking with RA patients and promoting the benefits of stopping.