Smoking Linked to 2x Higher Risk of Premature Death in Rheumatoid Arthritis Patients

Smoking Linked to 2x Higher Risk of Premature Death in Rheumatoid Arthritis Patients

Smoking is associated with earlier death in people with rheumatoid arthritis, a correlation that significantly decreased upon smoking cessation, according to a study led by University of Manchester researchers. The article, “Smoking-related mortality in patients with early rheumatoid arthritis – a retrospective cohort study using the Clinical Practice Research Datalink,” was published in the journal Arthritis Care and Research.

While extensive evidence shows that tobacco smoking is associated with an increased risk of death in the general population, researchers at NIHR Manchester Musculoskeletal Biomedical Research Unit examined whether quitting smoking would impact mortality in patients with rheumatoid arthritis (RA). Smoking is a known risk factor for the development of this disease, and the prevalence of smoking is higher in people with RA than in the general population.

The most frequent causes of premature mortality in RA patients are cardiovascular disease, malignancies including lung cancer, severe infection, and respiratory diseases — conditions that might be attributed to cigarette smoking.

To investigate the association between smoking status, smoking cessation, and mortality in RA, researchers led by Rebecca Joseph, a research assistant at the Centre for Musculoskeletal Research, identified people using the Clinical Practice Research Datalink, a database of U.K. primary care electronic medical records that includes information on hospital admissions and death certificates. The study cohort comprised 5,677 RA patients (median age, 61.4 years; 68 percent female), of which 40 percent had never smoked, 34 percent were former smokers, and 26  percent were current smokers at baseline.

Results revealed that compared to nonsmokers, current smokers had a two times higher risk of all-cause mortality and mortality due to circulatory disease and lung cancer. Each year of smoking cessation was associated with a decreased risk in all-cause mortality.

“This research provides important evidence that the risk of early death starts to decline in patients who stop smoking, and continues year on year. We hope that this research can be used by public health professionals and rheumatologists to help more people quit smoking and reduce premature deaths, particularly for newly diagnosed patients with rheumatoid arthritis,” Deborah Symmons, professor of Rheumatology and Musculoskeletal Epidemiology at Manchester, said in a news release.

Stephen Simpson, director of Research and Programmes at Arthritis Research UK, which supported study, added: “Rheumatoid arthritis is a debilitating and painful condition affecting over 400,000 people in the UK, it can begin at any age and is unpredictable — one day you can feel fine and the next day be confined to bed, unable to get up to dress …  As a charity, we are committed to preventing, transforming and curing arthritis and musculoskeletal diseases, and this research shows that cutting out smoking is one intervention which can help this condition from developing.”

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