Both rheumatoid arthritis (RA) and smoking cause inflammation in the body. This has led some researchers to investigate whether smoking may cause or exacerbate RA.

RA is an autoimmune disease in which the immune system mistakenly attacks healthy cells within the body. This results in inflammation in the joints as well as other body tissues and organs.

This article explores the link between smoking and RA and provides tips on how to quit smoking. It also outlines some other risk factors for RA.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Doctors do not fully understand the cause of RA. However, research supports the notion that certain environmental factors may activate genes that predispose a person to the condition. Smoking cigarettes is one such risk factor.

Both RA and smoking cause chronic inflammation within the body. The inflammatory effects of smoking may contribute to the development of RA or may add to the inflammatory effects of preexisting RA.

Authors of a 2018 study identified an association between smoking and a higher likelihood of developing RA. However, this was only the case among people who had smoked more than a pack of cigarettes per day for 2.5 years or more, or the equivalent number of cigarettes over fewer years.

A 2019 study involving 230,732 women found a correlation between smoking and the occurrence of RA. The study also found that quitting smoking decreased a person’s risk of RA. The longer a person had been a nonsmoker, the lower was their risk of developing the condition.

Moreover, in a 2017 study, researchers identified a link between secondhand smoke exposure and a worsening of RA symptoms among women with RA. The researchers suggest that smoke exposure might somehow trigger RA, such as by activating genes that predispose a person to the condition.

Despite all these findings, the link between smoking and RA remains complex. Not all smokers develop RA, and not all people with RA smoke.

Instead, it is likely that smoking is one of many environmental risk factors that may increase the likelihood of RA occurring in susceptible individuals.

Smoking may increase the risk of RA complications in people who already have the condition.

A 2016 review outlines a possible link between RA and hearing loss. According to the review, smoking can cause inflammation of the blood vessels, which may further increase the risk of hearing loss in people with RA.

Smoking also increases the risk of cardiovascular diseases that can limit a person’s ability to exercise.

Since physical activity plays an important role in the management of RA, smoking may negatively affect the prognosis of the condition.

According to the Centers for Disease Control and Prevention (CDC), the following may increase a person’s likelihood of developing RA:

  • aging
  • being female
  • being female and never having given birth
  • having obesity
  • having a family history of RA
  • experiencing exposure to certain harmful chemicals, such as cigarette smoke

Quitting smoking can be very challenging. This is because the nicotine in cigarettes is highly addictive, and it takes time for the body and mind to adapt to absence of nicotine.

People who have recently stopped smoking may experience withdrawal symptoms, such as:

People can try the following strategies to increase their odds of quitting smoking:

  • Plan a quit date in advance: Planning a quit date allows a person time to prepare for quitting. Where possible, people should plan to quit at a time of low stress, and should try to ensure they have adequate support in place. This may be in the form of a quit-smoking program, supportive friends and family, or engaging activities or hobbies.
  • Quit completely rather than just cutting back: Quitting completely allows nicotine to leave the body faster. Withdrawal will happen more immediately, but it will also end more quickly. Research suggests smokers who quit outright rather than cut back have higher rates of success.
  • Consider joining a program to quit smoking: The right quit-smoking program offers support and reassurance that may make it easier for a person to quit the habit.
  • Ask a doctor about medication: Medication can help ease some withdrawal symptoms, such as depression and anxiety.
  • Plan a distraction: Engaging in an enjoyable activity can distract from thoughts about smoking and can make cravings easier to manage. Examples of such activities include gardening, walking a dog, or meeting up with a friend.

The course of RA, including its progression, will differ from person to person. However, smoking generally worsens the prognosis of individuals with the condition.

Smoking can cause inflammation that adds to the chronic inflammation due to RA. This can lead to a worsening of preexisting RA symptoms.

RA is a chronic condition that can worsen over time. However, medication can help a person manage it and slow its progression.

Emerging research suggests that smoking could reduce the effectiveness of certain RA drugs.

As such, people should notify a doctor if they smoke. The doctor will be able to recommend the most appropriate RA treatment and can direct people to resources to help them quit smoking.

RA is a chronic autoimmune condition. A number of factors can contribute to the development of RA and to the worsening of its symptoms. Smoking is one such factor.

If people with RA who smoke quit smoking, they may notice some benefits, such as a reduction of severity of RA symptoms, and a better response to RA medication.

A doctor can help a person develop a quit-smoking plan and offer strategies to lower smoking-related health risks.