Smokers with rheumatoid arthritis face extra barriers to quitting

Smokers who suffer from Rheumatoid Arthritis (RA) may need more targeted support to successfully quit a habit that will likely worsen their disease, latest University of Otago research suggests.

An in-depth study of 36 South Island Rheumatoid Arthritis patients found that issues relating to their disease, such as smoking to distract themselves from pain or to cope with day-to-day frustrations the condition causes, were among their barriers to quitting.

RA is the second most common form of arthritis and, in New Zealand, affects 1-2% of the population. It is three times more common in women than men.

PhD student Pip Aimer, who undertook the study, says smoking is a significant risk factor for developing RA. International guidelines recommend such patients quit smoking to avoid adding to the existing cardiovascular and osteoporosis risks that the disease poses.

"We found that nearly two-thirds of the study participants were unaware of a relationship between smoking and RA. Only six reported changes in their smoking patterns after diagnosis and these participants started smoking more heavily," says Ms Aimer.

The participants also reported finding it difficult to exercise so were unable to use this as an alternative distraction from their pain, she says.

Ms Aimer says that the study suggests that alongside standard medications and counselling, smoking cessation strategies for smokers with RA should be tailored to their specific needs.

"This might include education about the relationship between smoking and RA and identifying suitable targeted exercise for each patient. Their chances of quitting smoking—and staying quit—could also be boosted by improving how their pain is managed, and helping them to develop alternative coping strategies," she says.

The study appears in the US journal Arthritis Care & Research and was supported by the Health Research Council and Arthritis New Zealand.

Ms Aimer's co-authors include her PhD supervisors Dr Gareth Treharne of the University's Department of Psychology and Professors Lisa Stamp and Vicky Cameron of the University of Otago, Christchurch, Department of Medicine.