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Impact, Timing of Smoking Cessation on RA Risk

Arthritis Care Res; ePub 2019 Feb 21; Liu, et al

Smoking is a strong risk factor for seropositive rheumatoid arthritis (RA), according to a recent study, and these findings demonstrate for the first time that a behavior change of sustained smoking cessation could delay or even prevent seropositive RA. Researchers investigated smoking cessation and RA risk in the Nurses’ Health Study (NHS, 1976‐2014) and the NHSII (1989‐2015). Smoking exposures and covariates were obtained by biennial questionnaires. Self‐reported RA was confirmed by medical record review for ACR/EULAR criteria. They found:

  • Among 230,732 women, 1,528 incident RA cases were identified (63.4% seropositive) during 6,037,151 person‐years of follow‐up.
  • Compared to never smoking, current smoking increased risk for all RA (multivariable HR 1.47) and seropositive RA (HR 1.67), but not seronegative RA (HR 1.20).
  • Increasing smoking pack‐years was associated with increased trend of risk for all RA and seropositive RA.
  • With increasing duration of smoking cessation, a decreased trend was observed in risk for all RA and seropositive RA.
  • Compared to recent quitters (<5 years), those who quit ≥30 years ago had HR of 0.63 for seropositive RA.


Liu X, Tedeschi SK, Barbhaiya M, et al. Impact and timing of smoking cessation on reducing risk for rheumatoid arthritis among women in the Nurses’ Health Studies. [Published online ahead of print February 21, 2019]. Arthritis Care Res. doi:10.1002/acr.23837.