Cigarette Smoking and Rheumatoid Arthritis

Woman resting head on arms, cigarette and ashtray in foreground
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Cigarette smoking is a bad habit with health consequences. Most people know lung cancer can be an unhealthy consequence of cigarette smoking, but it's not just lung cancer. Even rheumatoid arthritis (RA) has been linked to cigarette smoking.

"Cigarette smoking may increase the risk of developing rheumatoid arthritis. There is also some evidence that cigarette smoking increases the likelihood that rheumatoid arthritis will be severe when it occurs.

"Because of an increased risk of coronary atherosclerosis and associated morbidity and mortality in patients with RA, efforts to modify risk factors such as cigarette smoking, hyperlipidemia, hypertension, and sedentary life style should accompany treatment directed at RA."

How Much Extra Risk?

Nearly a decade ago, at the American College of Rheumatology Annual Scientific Meeting in October/November 2000, researchers reported that the risk of developing rheumatoid arthritis is nearly double for current smokers compared to non-smokers. The risk of developing rheumatoid arthritis is lower for former smokers compared to current smokers, but higher than for people who never smoked. In one study, women who were smokers but had stopped at least 10 years prior to the start of the study did not have an increased risk.

Are Men or Women More Affected?

From a meta-analysis of 16 studies, it was concluded that the strongest association between smoking and rheumatoid arthritis occurred in men who were positive for rheumatoid factor. When parameters were limited to rheumatoid factor positive patients, men had double the odds ratio of women.

Should You Stop Smoking?

Study results, presented at American College of Rheumatology Annual Scientific Meeting in October 2008, showed that measures of active disease—including swollen and tender joint counts and C-reactive protein—​were lower in patients who had stopped smoking.

This suggests that, even after you have rheumatoid arthritis, if you stop smoking you can lessen rheumatoid arthritis disease activity.


Impact of smoking as a risk factor for developing rheumatoid arthritis: A meta-analysis of observational studies. Annals of the Rheumatic Diseases. Daisuke Sugiyama et al. Published online January 27, 2009.​

Maini, RN and Venables PJW, "Patient information: Rheumatoid arthritis symptoms and diagnosis." UpToDate. Accessed September 30, 2009.