Passive smoking in childhood increases the risk of developing rheumatoid arthritis

Séror, Raphaèle; Henry, J.; Gusto, Gaëlle; Aubin, H; Boutron-Ruault, Marie Christine; Mariette, Xavier

doi:10.1093/rheumatology/key219

Cited by 46 publications

(42 citation statements)

References 21 publications

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“…Thus, high levels of passive smoke exposure may place individuals at higher risk for RA, even among smokers. This finding may explain why an association of passive smoking with RA was suggested in 2 other studies, especially among individuals with a longer duration of exposure extending back to childhood (10,18).…”

Section: Discussionmentioning

confidence: 61%

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: 61%

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

Kronzer

Crowson

Sparks

et al. 2019

Arthritis & Rheumatology

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“…In a large meta‐analysis that included 11 studies , 13,885 RA cases among a total of 593,576 individuals, current‐smokers had an odds ratio (OR) of 1.64 for seropositive RA compared to never‐smokers. Recent results from the French E3N cohort study in which 71,248 women were prospectively followed since 1990 showed that past‐smokers (HR 1.32, 95% CI 1.06‐1.64) and current‐smokers (HR 1.57, 95% CI 1.13–2.19) had an increased RA risk compared to never‐smokers . Our group previously investigated smoking performed only in the NHS using follow‐up data from 1976 to 2002 and demonstrated that current‐ smokers had an HR of 1.46 (95% CI 1.20–1.79) for all RA and HR of 1.58 (95% CI 1.21–2.06) for seropositive RA compared to never‐smokers .…”

Section: Discussionmentioning

confidence: 93%

“…Although the etiology of rheumatoid arthritis (RA) remains obscure, previous studies have implicated smoking as an important and potentially modifiable risk factor for the development of RA . Previous epidemiologic studies have identified cigarette smoking as one of the most important lifestyle risk factors for the development of RA and particularly seropositive RA, which is defined as the presence of rheumatoid factor (RF) or anti–cyclic citrullinated peptide (anti‐CCP) .…”

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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“…Given previous associations of active and passive smoking with risk of COPD , asthma , and RA , adjustment for those was an important aspect of our analysis. On the baseline questionnaire, participants reported smoking status (never/past/current) and age at which they started smoking.…”

Section: Methodsmentioning

confidence: 99%

Asthma, Chronic Obstructive Pulmonary Disease, and Subsequent Risk for Incident Rheumatoid Arthritis Among Women: A Prospective Cohort Study

Ford

Liu

Chu

et al. 2020

Arthritis & Rheumatology

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Objective. Inflamed airways are hypothesized to contribute to rheumatoid arthritis (RA) pathogenesis due to RA-related autoantibody production, and smoking is the strongest environmental RA risk factor. However, the role of chronic airway diseases in RA development is unclear. We undertook this study to investigate whether asthma and chronic obstructive pulmonary disease (COPD) were each associated with RA.Methods. We performed a prospective cohort study of 205,153 women in the Nurses' Health Study (NHS, 1988(NHS, -2014 and NHSII (1991NHSII ( -2015. Exposures were self-reported physician-diagnosed asthma or COPD confirmed by validated supplemental questionnaires. The primary outcome was incident RA confirmed by medical record review by 2 rheumatologists. Covariates (including smoking pack-years/status) were assessed via biennial questionnaires. Multivariable hazard ratios (HRs) and 95% confidence intervals (CIs) for RA were estimated using Cox regression.Results. We identified 15,148 women with confirmed asthma, 3,573 women with confirmed COPD, and 1,060 incident RA cases during 4,384,471 person-years (median 24.0 years/participant) of follow-up in the NHS and NHSII. Asthma was associated with increased RA risk (HR 1.53 [95% CI 1.24-1.88]) compared to no asthma/COPD after adjustment for covariates, including smoking pack-years/status. Asthma remained associated with increased RA risk when analyzing only never-smokers (HR 1.53 [95% CI 1.14-2.05]). COPD was also associated with increased RA risk (HR 1.89 [95% CI 1.31-2.75]). The association of COPD with RA was most pronounced in the subgroup of eversmokers age >55 years (HR 2.20 [95% CI 1.38-3.51]).Conclusion. Asthma and COPD were each associated with increased risk of incident RA, independent of smoking status/intensity and other potential confounders. These results provide support for the hypothesis that chronic airway inflammation may be crucial in RA pathogenesis.

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Passive smoking in childhood increases the risk of developing rheumatoid arthritis

Cited by 46 publications

References 21 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

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

Asthma, Chronic Obstructive Pulmonary Disease, and Subsequent Risk for Incident Rheumatoid Arthritis Among Women: A Prospective Cohort Study

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