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Smoking and Higher Disease Activity in RA

Smoking is associated with higher levels of disease activity in patients with rheumatoid arthritis (RA), a new study found. Researchers examined the association between smoking and RA in 282 individuals with RA diagnosis, in a public hospital, between 2013 and 2017. Current smoking status and disease activity were assessed at each visit; covariates included sex, race/ethnicity, age, obesity, and medication use. Among the findings:

  • Smoking was associated with an increase of 0.64 units in the patient global score compared to nonsmoking and with 2.58 more swollen joints.
  • Smoking was associated with a higher clinical disease activity score; however, the difference was not statistically significant.
  • No association was found between smoking and tender joint count.


Gianfrancesco MA, Trupin L, Shiboski S, et al. Smoking is associated with higher disease activity in rheumatoid arthritis: A longitudinal study controlling for time-varying covariates. J Rheumatol. 2019;46(4):370-375. doi:10.3899/jrheum.180262.