Smoking Cessation in Rheumatoid Arthritis
Importance of Smoking Cessation
- Patients with rheumatoid arthritis who smoke must be strongly counseled to quit immediately at every clinical encounter, as smoking worsens disease activity, accelerates structural damage, impairs DMARD treatment response, increases comorbidities including cardiovascular disease, and reduces quality of life 1
- Smoking negatively impacts symptoms, function, disease activity, disease progression, and occurrence of comorbidities across all rheumatic and musculoskeletal diseases 1
- Smoking may limit response to disease-modifying antirheumatic drugs (DMARDs), meaning patients who smoke may not respond as well to their RA medications 1
- Smoking contributes to higher absolute cardiovascular risk in individual RA patients, compounding the already elevated cardiovascular disease risk inherent to RA itself 2, 3
Evidence-Based Cessation Approach
- Rheumatologists are strongly recommended to advise and help their patients to stop smoking at every encounter, using best evidence-based methods 2, 3
- The trust developed between RA patients and their clinicians makes counseling particularly important, despite the low success rate of individual tobacco cessation counseling efforts 4