Definition

Objective:

To investigate the association between smoking status and smoking cessation with mortality in patients with rheumatoid arthritis (RA).

Methods:

An incident cohort of patients with RA was identified using the Clinical Practice Research Datalink, a database of UK primary care electronic medical records. Time-varying smoking status, years of cessation, and amount smoked were determined frompatients’medical records. The date and underlying cause of deathwere identified by linkagewith Office for National Statistics records. The associations between smoking status and smoking cessation with all-cause and causespecific mortality (circulatory disease, all cancers, lung cancer, respiratory disease, and respiratory infection) were investigated using adjusted Cox (all-causemortality) and Fine-Gray (cause-specificmortality) regression.

Results:

The cohort comprised 5,677 patients (median age 61.4 years, 68% women), with 40% as never smokers, 34% former smokers, and 26% current smokers at baseline. Compared to never smoking, current smokingwas associated with an increased risk of all-causemortality (hazard ratio 1.98 [95% confidence interval (95% CI) 1.56, 2.53]), andmortality due to circulatory disease (subdistribution hazard ratio [SHR] 1.96 [95% CI 1.33, 2.90]) and lung cancer (SHR 23.2 [95% CI 5.15, 105]). Each year of smoking cessation was associated with a decreased risk of all-cause mortality (former heavy smokers SHR 0.85 [95% CI 0.77, 0.94], former light smokers SHR 0.90 [95%CI 0.84, 0.97]).

Conclusion:

Current smoking is associated with an increased risk of all-cause, cardiovascular, and lung cancermortality in patientswith RA. Each year of cessation is associated with a reduced risk of all-causemortality. This information may prove helpful in smoking cessation programs for patients with RA.

Publications

Clinical Code List

Export Code List

• CSV
• JSON
• XML