RESEARCH - Quantification of the influence of cigarette smoking on RA

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Ann Rheum Dis. 2003 Sep;62(9):835-41.

Quantification of the influence of cigarette smoking on rheumatoid

arthritis: results from a population based case-control study, using

incident cases.

Stolt P, Bengtsson C, Nordmark B, Lindblad S, Lundberg I, Klareskog L,

Alfredsson L; EIRA study group.

Institute of Environmental Medicine, Karolinska Institutet, Box 210,

S-171 77 Stockholm, Sweden.

OBJECTIVE: To quantify the influence of cigarette smoking on the risk

of developing rheumatoid arthritis (RA).

METHODS: 679 cases and 847 controls included during May 1996-June 2000

in a case-control study, using incident cases, comprising the

population aged 18-70 years of a defined area of Sweden, were

investigated. A case was defined as a person from the study base who

received for the first time a diagnosis of RA using the 1987 American

College of Rheumatology criteria, and controls were randomly selected

from the study base. Self reported smoking habits among cases and

controls, and rheumatoid factor status among cases were registered.

The incidence of RA in current smokers, ex-smokers, and ever-smokers,

respectively, was compared with that of never-smokers.

RESULTS: Current smokers, ex-smokers, and ever-smokers of both sexes

had an increased risk for seropositive RA (for ever-smokers the odds

ratio was 1.7 (95% confidence interval (95% CI) 1.2 to 2.3) for women,

and 1.9 (95% CI 1.0 to 3.5) for men), but not for seronegative RA. The

increased risk was only apparent among subjects who had smoked > or

=20 years, was evident at an intensity of smoking of 6-9

cigarettes/day, and remained for up to 10-19 years after smoking

cessation. The risk increased with increasing cumulative dose of

smoking.

CONCLUSION: Smokers of both sexes have an increased risk of developing

seropositive, but not seronegative, RA. The increased risk occurs

after a long duration, but merely a moderate intensity, of smoking and

may remain for several years after smoking cessation.

PMID: 12922955

http://www.ncbi.nlm.nih.gov/pubmed/12922955

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