Smoking associated with reduced odds of Sjögren's syndrome among rheumatoid arthritis patients

Evaluation of an individually tailored smoking-cessation intervention for patients with rheumatoid arthritis in an outpatient clinic

OBJECTIVE

The aim of this study was to evaluate an individually tailored smoking-cessation intervention delivered in rheumatology care and compare the characteristics of patients who quit smoking with those who did not.

METHOD

This was an open single-group prospective intervention study over 24 months, with assessments at baseline and at 6, 12, 18, and 24 months. Current smokers with rheumatoid arthritis (RA) were invited to a smoking-cessation programme including behavioural change support, with or without pharmacotherapy. Data on disease activity, medical treatment, and patient-reported outcomes were retrieved from the Swedish Rheumatology Quality Register. The primary outcome was the proportion of patients at month 24 who reported having quit smoking with self-reported 7 day smoking abstinence.

RESULTS

In total, 99 patients participated in the study. Median age was 58 years (interquartile range 50-64); 69% were female and 88% rheumatoid factor and/or anti-cyclic citrullinated peptide positive. At 24 months, 21% of the patients had quit smoking. At 6, 12, and 18 months, 12%, 12%, and 14% of patients, respectively, had quit smoking. For patients still smoking at 24 months, the median number of cigarettes per day was significantly reduced from 12 to 6 (p ≤ 0.001). Among patients who had quit smoking at 24 months, a smaller proportion reported anxiety at baseline compared to those still smoking (28% vs 58%, p = 0.02).

CONCLUSION

A smoking-cessation intervention including behavioural change support with or without pharmacotherapy can be helpful for a substantial number of RA patients. Anxiety is associated with lower smoking-cessation success rates.

Smoking, Obesity, and Risk of Primary Sjögren Syndrome

I read the paper by Servioli et al¹ conducting a 1:3 case-control study to evaluate the association between smoking status and primary (p-) Sjögren syndrome (SS). ORs (95% CIs) of current and former smokers compared to never smokers for pSS were 0.34 (0.14-0.85) and 1.27 (0.80-2.03), respectively. In contrast, there was no significant association of smoking status with antinuclear antibody, anti-SSA, anti-SSB, or rheumatoid factor positivity.

Dr. Berti et al reply

We read with interest the comment of Dr. Kawada¹ on our article that showed an inverse association between current smoking status and primary (p-) Sjögren syndrome (SS), and no association between obesity and pSS.².