World No Tobacco Day: How smoking can cause 'Rheumatoid arthritis'; read details

We spoke to Dr Abhishek Patil, Consultant - Rheumatology, Manipal Hospital, Old Airport Road, who told us how cigarette smoking could develop rheumatoid arthritis RA).   

Rheumatoid arthritis (RA) is a chronic inflammatory disease which is caused by both genetic and environmental factors. It results from one’s immune system attacking their own joint tissues. RA has many physical and social consequences and lowers the quality of life. 

Rheumatoid arthritis can cause unbearable pain, disability, and premature death. Cigarette smoking is the strongest lifestyle risk factor for the development of rheumatoid arthritis. 

It is evident through studies that smokers are at two times higher risk of developing RA compared to non-smokers. Several studies have also hinted toward the possibility of children exposed to passive smoking is more susceptible to the development of RA in future. It has also been noted that higher doses of smoking are associated with greater joint damage and more aggressive forms of RA. 

Smoking can cause oxidative stress in the body which contributes to increased inflammation. Cigarette smoke acts by altering the structure of native joint proteins by a process called citrullination and thus making them susceptible to immune recognition and subsequent damage. 

Apart from increasing the severity, smoking also contributes to an accelerated risk of cardiovascular disease and cancer in RA patients. It can also contribute significantly to lung damage which is seen in nearly 1/3rd of patients with RA. Smoking also diminishes the effectiveness of medications used in the treatment of RA.

In RA patients, smoking cessation could significantly improve the outcome and lower the risk of progression of arthritis. Hence its important for the caregivers involved in the care of RA patients to actively educate the patients regarding the importance of smoking cessation. 

RA Patients can seek the help of their rheumatologists and deaddiction centres to discontinue their smoking habits gradually. Its also necessary to address other lifestyle factors such as alcohol, and obesity and undertake proper nutrition/ exercise to lower the risk of RA.