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Data is accumulating on the negative impact of smoking on many rheumatic diseases.
Today there was a poster from Spain examining the impact of smoking on clinical and structural damage in patients with AS and aSpA. The researchers performed a systematic literature review up to November 2014 and identified 13 studies for inclusion with data on over 4000 patients. There were 7 case control and 6 cohort studies evaluated.
Current smokers with AS had higher disease activity, poorer quality of life and more pain, independent of age, sex, disease duration and social support. There was a significant association with smoking and progression of functional disability in patients with AS of less than 10 years' duration. The authors concluded that smoking cessation should be recommended to patients with AS at diagnosis as well as follow-up. Larger scale studies with longer follow-up including x-ray data are needed.
Similar to the story with RA, it would be interesting to know more about response to treatment in smokers vs non smokers. Of all the lifestyle discussions I have with my patients, smoking cessation is the one which seems to surprise them coming from their rheumatologist. They know about other negative effects of smoking but not how it relates to their arthritis. I try to at least start the preliminary discussion and pass on pamphlets for reading on smoking cessation but so much more is required for success in quitting. How we as rheumatologists can be most effective in this challenging venture is a work in progress.
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About the Author
Dr. Shelly Dunne
Dr. Shelley Dunne is a graduate of Memorial University of Newfoundland School of Medicine. She completed her training in Internal Medicine and a fellowship in Rheumatology at the University of Toronto. She has been in private practice since 1998 and is currently a consulting rheumatologist at the Toronto East General Hospital.
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