Smoking status and associated clinical characteristics in patients with rheumatoid arthritis

Background. Smoking is one of the main proven environmental factors exacerbating the course and effectiveness of rheumatoid arthritis (RA) therapy. The aim of the study was to analyze the smoking status of patients with RA, its associations with the manifestations of the disease and comorbidities, as well as the attitude of Russian rheumatologists to the problem of tobacco smoking among patients with RA.

Materials and methods. A comparative analysis of the records of 2,702 smoking and non-smoking RA patients from the rheumatology hospital registry, the results of a survey of 194 smokers with RA and an anonymous survey of rheumatologists were conducted.

Results. Compared with non-smoking RA patients, smokers were more likely to have seropositive RA (p=0.001) and higher disease activity (p=0.0002). A positive association of smoking with COPD (p< 0.001), tuberculosis (p=0.008) and peptic ulcer of the stomach and duodenum (p < 0.001) was found. Patients with a high frequency of cardiovascular diseases quit smoking. Smoking was characterized by a long duration and high intensity. Every fifth smoker had a high motivation to quit smoking, 71% made unsuccessful attempts. The majority of rheumatologists are convinced of the negative effects of smoking on RA, but they are not familiar with the principles of counseling smokers.

Conclusion. The study substantiates the relevance of the development and implementation in clinical practice of educational programs on smoking cessation in RA.