Exposure to passive smoking and rheumatoid arthritis risk: results from the Swedish EIRA study

Hedström, Anna Karin; Klareskog, Lars; Alfredsson, Lars

doi:10.1136/annrheumdis-2018-212973

Cited by 24 publications

(18 citation statements)

References 10 publications

(7 reference statements)

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“…Passive smoke exposure at home or the workplace, including the age the exposure began, duration, intensity, and pack‐years, was not associated with RA. A prior study also showed no evidence of association when combining home and workplace exposure . However, because information about the intensity of smoke exposure was not collected in that study, the dose‐response effect was not evaluated.…”

Section: Discussionmentioning

confidence: 88%

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Investigating Asthma, Allergic Disease, Passive Smoke Exposure, and Risk of Rheumatoid Arthritis

Kronzer

Crowson

Sparks

et al. 2019

Arthritis & Rheumatology

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Objective Rheumatoid arthritis (RA) is postulated to originate at mucosal surfaces, particularly the airway mucosa. To investigate this hypothesis, we determined the association between RA and asthma, passive smoke exposure, and age at start of smoking. Methods For this case–control study, we identified 1,023 cases of RA (175 incident) within a single‐center biobank population, using a rules‐based algorithm that combined self‐report with 2 diagnostic codes. Exposures were self‐reported on biobank questionnaires. Logistic regression models were used to calculate the association of exposures with RA, adjusting for potential confounders. Odds ratios (ORs) with 95% confidence intervals (95% CIs) were calculated. Results After adjustment for allergies, urban environment, and passive smoke exposure, asthma was found to be associated with RA in the full cohort (OR 1.28 [95% CI 1.04–1.58; P = 0.02]) but not the incident RA cohort (OR 1.17 [95% CI 0.66–2.06; P = 0.60]). History of allergic disease was associated with RA in both the full cohort (OR 1.30 [95% CI 1.12–1.51; P < 0.001]) and the incident RA cohort (OR 1.61 [95% CI 1.11–2.33; P = 0.01]), especially food allergy, which was significantly associated with RA in the full cohort (OR 1.38 [95% CI 1.08–1.75; P = 0.01]) and showed a trend toward significance in the incident RA cohort (OR 1.83 [95% CI 0.97–3.45; P = 0.06]). Passive smoke exposure at home or work was not associated with RA. Finally, age at start of smoking was not associated with increased odds of developing RA in either the full cohort (OR 1.03 [95% CI 1.00–1.06; P = 0.03]) or the incident RA cohort (OR 1.00 [95% CI 0.92–1.08; P = 0.98]). Conclusion Asthma and allergies may be associated with increased risk of RA. Passive smoke exposure and early age at start of smoking do not appear to influence risk of RA.

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Section: Discussionmentioning

confidence: 88%

“…Finally, for many study participants, data on RA autoantibody status were not available, limiting the number of calculations that could be performed in the sensitivity analysis. Notably, Hedstrom et al showed no difference in the association between passive smoke and RA by antibody status (17).…”

Section: Discussionmentioning

confidence: 98%

Investigating Asthma, Allergic Disease, Passive Smoke Exposure, and Risk of Rheumatoid Arthritis

Kronzer

Crowson

Sparks

et al. 2019

Arthritis & Rheumatology

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“…The most prominent factor is general socio-economic status. Thus, even after correction Passive smoking (as adult) À À À [202,203] Snuff use À À À [74,75] Occup. exp to silica + + + /À [76][77][78][79] Occup.…”

Section: Other Environmental Risk Factorsmentioning

confidence: 99%

The importance of differences; On environment and its interactions with genes and immunity in the causation of rheumatoid arthritis

et al. 2020

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“…Previous studies have investigated the association between smoking status, intensity, duration, and pack‐years and the risk of RA . However, only a few studies have investigated whether smoking cessation might reduce the risk of developing RA .…”

Section: Introductionmentioning

confidence: 99%

Impact and Timing of Smoking Cessation on Reducing Risk of Rheumatoid Arthritis Among Women in the Nurses’ Health Studies

Liu

Tedeschi

Barbhaiya

et al. 2019

Arthritis Care & Research

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Objective. To investigate the impact and timing of smoking cessation on developing rheumatoid arthritis (RA) and serologic phenotypes.Methods. We investigated smoking cessation and RA risk in the Nurses' Health Study (NHS) and the NHS II . Smoking exposures and covariates were obtained by biennial questionnaires. Self-reported RA was confirmed by medical record review for American College of Rheumatology/European League Against Rheumatism criteria. Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for RA serologic phenotypes (all, seropositive, seronegative) according to smoking status, intensity, pack-years, and years since cessation.Results. Among 230,732 women, we identified 1,528 incident cases of RA (63.4% of which were seropositive) during 6,037,151 person-years of follow-up. Compared with never smoking, current smoking increased the risk of all RA (multivariable HR 1.47, 95% CI 1.27-1.72) and seropositive RA (HR 1.67, 95% CI 1.38-2.01) but not seronegative RA (HR 1.20, 95% CI 0.93-1.55). An increasing number of smoking pack-years was associated with an increased trend for the risk of all RA (P < 0.0001) and seropositive RA (P < 0.0001). With increasing duration of smoking cessation, a decreased trend for the risk of all RA was observed (P = 0.009) and seropositive RA (P = 0.002). Compared to recent quitters (<5 years), those who quit ≥30 years ago had an HR of 0.63 (95% CI 0.44-0.90) for seropositive RA. However, a modestly increased risk of RA was still detectable 30 years after quitting smoking (for all RA, HR 1.25 [95% CI 1.02-1.53]; for seropositive RA, HR 1.30 [95% CI 1.01-1.68]; reference, never smoking).Conclusion. These results confirm that smoking is a strong risk factor for developing seropositive RA and demonstrate for the first time that a behavior change of sustained smoking cessation could delay or even prevent seropositive RA.

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Exposure to passive smoking and rheumatoid arthritis risk: results from the Swedish EIRA study

Cited by 24 publications

References 10 publications

Investigating Asthma, Allergic Disease, Passive Smoke Exposure, and Risk of Rheumatoid Arthritis

Investigating Asthma, Allergic Disease, Passive Smoke Exposure, and Risk of Rheumatoid Arthritis

The importance of differences; On environment and its interactions with genes and immunity in the causation of rheumatoid arthritis

Impact and Timing of Smoking Cessation on Reducing Risk of Rheumatoid Arthritis Among Women in the Nurses’ Health Studies

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