While there is evidence that smoking increases the risk for rapid radiographic progression in rheumatoid arthritis (RA), it had not been clear whether smoking cessation can delay or prevent onset of the disease.
Researchers at Brigham and Women’s Hospital investigated the impact and timing of smoking cessation on the development of seropositive and seronegative RA. They analyzed data from the Nurses’ Health Study, which began in 1976, and the Nurses’ Health Study II, which began 13 years after. Both cohorts investigate risk factors for chronic disease in women. Surveys deployed in the studies included questions about health status and smoking.
Among 230,732 participants, the investigators identified 1528 women who had developed RA. There were twice as many cases of seropositive RA (63.4%) as seronegative RA (36.6%).
Risk for seropositive RA began to decrease within 5 years of smoking cessation and was reduced by 37% after ≥30 years. No association was found between seronegative RA and smoking, suggesting that seropositive RA and seronegative RA are distinct diseases with different risk factors.
The researchers summarized their findings: “The results confirm smoking as a strong risk factor for seropositive RA and demonstrate for the first time that a behavior change of sustained smoking cessation could delay or even prevent seropositive RA.”
LiuX, 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 February 21, 2019]. Arthritis Care Res. doi: 10.1002/acr.23837