Arthritic Smokers Have 2x Mortality Rate of Non-Smokers

Smoking has always been problematic but evidence from a British study reveals that smoking can be more deadly for patients suffering from rheumatoid arthritis (RA). The study was conducted by Deborah P.M. Symmons, M.D., and her colleagues from the Manchester Musculoskeletal Biomedical Research Unit and published in Arthritis Care & Research.

They found in their study, which had a mean follow-up of around five years, death rates were more than double among the smokers compared with those who had never smoked. The study was reported by Pauline Anderson, a contributing writer for MedPage Today.

Anderson wrote that smokers were at significantly increased risk of death from any cause, as well as from the more common circulatory diseases and lung cancer.

Symmons and colleagues analyzed data from 5, 677 patients with RA. In the study group 67.8% of the participants were female and their median age at RA diagnosis was 61.4 years. The never-smokers made up 40.3% of the group, 34.1% were former smokers, and 25.6% were current smokers.

After adjustment for age and sex, the mortality rates for never, former, and current smokers translated into about 6 deaths per 1, 000 person-years attributable to former smoking, and 15 deaths per 1, 000 person-years attributable to current smoking.

Among former smokers, the mortality risk fell significantly each year after quitting. This was particularly true for those who had been heavy smokers. Current smokers had a significantly higher risk of death than never-smokers. According to Anderson, this higher risk persisted after adjustments that included socioeconomic status, body mass index, cardiovascular disease, and diabetes, among other factors.

The major cause of death was circulatory disease, with a mortality rate of 8.3 per 1, 000 person-years. In general, Anderson wrote, the age and sex adjusted mortality rates were lowest in those who had never smoked and highest in those who currently smoked.

Jeffrey A. Sparks, M.D., of Harvard Medical School, Boston, said “These results emphasize that smoking cessation programs should be a focus for patients newly diagnosed with RA.”