RESEARCH - Smoking intensity, duration, and cessation, and the risk of RA in women

[Guest guest]

Am J Med. 2006 Jun;119(6):503.e1-9.

Smoking intensity, duration, and cessation, and the risk of rheumatoid

arthritis in women.

Costenbader KH, Feskanich D, Mandl LA, Karlson EW.

Division of Rheumatology, Immunology, and Allergy, B. Brigham

Arthritis and Musculoskeletal Diseases Clinical Research Center, Brigham and

Women's Hospital, Harvard Medical School, Boston, Mass 02115, USA.

KCostenbader@...

BACKGROUND: Cigarette smoking has been associated with rheumatoid arthritis

(RA), but the importance of smoking intensity, duration, and time since

quitting, and whether the risk is primarily for rheumatoid factor (RF)

seropositive versus seronegative RA are still unclear. METHODS: We conducted

a prospective analysis of smoking and the risk of RA among 103,818 women in

the Nurses' Health Study. A total of 680 RA cases, diagnosed from 1976 and

2002, were confirmed using a questionnaire and medical record review. Sixty

percent were RF positive. proportional hazards models calculated the

relative risks (RRs) of RA with smoking, adjusting for reproductive and

lifestyle factors. RESULTS: The RR of RA was significantly elevated among

current (RR 1.43 [95% confidence interval 1.16-1.75]) and past smokers (RR

1.47 [95% confidence interval 1.23-1.76]), compared with never smokers. The

risk of RA was significantly elevated with 10 pack-years or more of smoking

and increased linearly with increasing pack-years (P trend <.01). A greater

number of daily cigarettes and longer duration of smoking were associated

with increased risk. The effect of smoking was much stronger among

RF-positive cases than among RF-negative cases. The risk remained elevated

in past smokers until 20 years or more after cessation.

CONCLUSIONS: In this large cohort, past and current cigarette smoking were

related to the development of RA, in particular seropositive RA. Both

smoking intensity and duration were directly related to risk, with prolonged

increased risk after cessation.

PMID: 16750964

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed & cmd=Retrieve & dopt=Abstra\

ct & list_uids=16750964

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[Guest guest]

I often wonder if I helped to bring on my RA by those 30+ years of

heavy smoking that I did. Of course there has to be more than smoking

involved, because all smokers don't get RA. All smokers with RA in

their families don't get it, either. My sister still smokes, and she

doesn't have RA.

Sue

On Sunday, December 17, 2006, at 11:05 AM, wrote:

>

> Smoking Intensity, Duration, and Cessation, and the Risk of Rheumatoid

> Arthritis in Women

[Guest guest]

Hi !

Thanks for this, I'm lazy today and really needed a bit of motivation to

work on my stop smoking course this morning!

These articles always make me feel like a total idiot for having being a

smoker. We always think we'll quit before it causes us to be sick but I was

only 25 years old when I got RA and who knows if I would ever have had it if

I'd never started smoking. Kind of irritating!

It does make me feel like a real crusader though (in a good and not pedantic

way ;-) to try and help anyone else who is trying to stop this pointless

weed. I think I've found my calling - ha ha!

Take care,

Heidi

[ ] RESEARCH - Smoking intensity, duration, and

cessation, and the risk of RA in women

The American Journal of Medicine

Volume 119, Issue 6 , June 2006, Pages 503.e1-503.e9

Clinical research study

Smoking Intensity, Duration, and Cessation, and the Risk of Rheumatoid

Arthritis in Women

H. Costenbader MD, MPHa, b, , , Diane Feskanich ScDb, A. Mandl

MD, MPHc and W. Karlson MDa, b

aDivision of Rheumatology, Immunology, and Allergy, Section of Clinical

Sciences, B. Brigham Arthritis and Musculoskeletal Diseases

Clinical

Research Center, Brigham and Women's Hospital, Harvard Medical School,

Boston, Mass

bChanning Laboratory, Department of Medicine, Brigham and Women's Hospital

and Harvard Medical School, Boston, Mass

cDivision of Rheumatology, Department of Medicine, Hospital For Special

Surgery, Cornell Weill Medical College, New York.

Abstract

Background

Cigarette smoking has been associated with rheumatoid arthritis (RA), but

the importance of smoking intensity, duration, and time since quitting,

and

whether the risk is primarily for rheumatoid factor (RF) seropositive

versus

seronegative RA are still unclear.

Methods

We conducted a prospective analysis of smoking and the risk of RA among

103,818 women in the Nurses' Health Study. A total of 680 RA cases,

diagnosed from 1976 and 2002, were confirmed using a questionnaire and

medical record review. Sixty percent were RF positive. proportional

hazards models calculated the relative risks (RRs) of RA with smoking,

adjusting for reproductive and lifestyle factors.

Results

The RR of RA was significantly elevated among current (RR 1.43 [95%

confidence interval 1.16-1.75]) and past smokers (RR 1.47 [95% confidence

interval 1.23-1.76]), compared with never smokers. The risk of RA was

significantly elevated with 10 pack-years or more of smoking and increased

linearly with increasing pack-years (P trend <.01). A greater number of

daily cigarettes and longer duration of smoking were associated with

increased risk. The effect of smoking was much stronger among RF-positive

cases than among RF-negative cases. The risk remained elevated in past

smokers until 20 years or more after cessation.

Conclusions

In this large cohort, past and current cigarette smoking were related to

the

development of RA, in particular seropositive RA. Both smoking intensity

and

duration were directly related to risk, with prolonged increased risk

after

cessation.

http://www.sciencedirect.com/science?_ob=ArticleURL & _udi=B6TDC-4K3K9GK-C & _

coverDate=06%2F30%2F2006 & _alid=509817333 & _rdoc=1 & _fmt= & _orig=search & _qd=1 & _c

di=5195 & _sort=d & view=c & _acct=C000050221 & _version=1 & _urlVersion=0 & _userid=10 &

md5=dc8a00cfdd3f964ade1a0bdb24d1ec67

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

[Guest guest]

Sue, I wonder, too, but I don't think RA is brought on by any single cause.

It's probably an unlucky combination of things that cause the immune system

to go awry - genes and environment both.

The important thing is that you quit!

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

Re: [ ] RESEARCH - Smoking intensity, duration, and

cessation, and the risk of RA in women

>I often wonder if I helped to bring on my RA by those 30+ years of

> heavy smoking that I did. Of course there has to be more than smoking

> involved, because all smokers don't get RA. All smokers with RA in

> their families don't get it, either. My sister still smokes, and she

> doesn't have RA.

>

> Sue

>

> On Sunday, December 17, 2006, at 11:05 AM, wrote:

>>

>> Smoking Intensity, Duration, and Cessation, and the Risk of Rheumatoid

>> Arthritis in Women

[Guest guest]

LOL. Don't beat yourself up, Heidi. There are plenty of nonsmokers who have

RA and lots of smokers who don't have RA. The important thing is that you

quit.

Not an MD

I'll tell you where to go!

Mayo Clinic in Rochester

http://www.mayoclinic.org/rochester

s Hopkins Medicine

http://www.hopkinsmedicine.org

RE: [ ] RESEARCH - Smoking intensity, duration, and

cessation, and the risk of RA in women

> Hi !

>

> Thanks for this, I'm lazy today and really needed a bit of motivation to

> work on my stop smoking course this morning!

>

> These articles always make me feel like a total idiot for having being a

> smoker. We always think we'll quit before it causes us to be sick but I

> was

> only 25 years old when I got RA and who knows if I would ever have had it

> if

> I'd never started smoking. Kind of irritating!

>

> It does make me feel like a real crusader though (in a good and not

> pedantic

> way ;-) to try and help anyone else who is trying to stop this pointless

> weed. I think I've found my calling - ha ha!

>

> Take care,

> Heidi