J Rheum Dis 2019; 26(1): 12-19  
Smoking as a Preventable Risk Factor for Rheumatoid Arthritis: Rationale for Smoking Cessation Treatment in Patients with Rheumatoid Arthritis
Sungwon Roh
Department of Psychiatry, Hanyang University College of Medicine, Seoul, Korea
Correspondence to: Sungwon Roh http://orcid.org/0000-0003-4557-3542
Department of Psychiatry, Hanyang University College of Medicine, 222 Wangsimni-ro, Seongdong-gu, Seoul 04763, Korea. E-mail:swroh@hanyang.ac.kr
Received: June 18, 2018; Revised: September 27, 2018; Accepted: October 15, 2018; Published online: January 1, 2019.
© Korean College of Rheumatology. All rights reserved.

This is a open Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Rheumatoid arthritis (RA) is a chronic inflammatory disease of multifactorial etiology. Smoking is considered one of the most established environmental risk factors for RA development and severity. A large proportion of patients with RA have a high prevalence of smoking history. Previous studies have provided evidence suggesting that smoking is associated with the development of RA. Smoking has been associated with several pathogenic mechanisms on RA development such as oxidative stress, inflammation, and epigenetic changes. There is a need for public health campaigns to educate the public regarding these risks and preventive measures that reduce smoking are essential and may result in a decline in RA incidence. Encouragement of smoking cessation is especially warranted in relatives of patients with RA. Recently, RA-specific smoking cessation interventions have been developed. This review will summarize the knowledge accumulated to date concerning associations between smoking and RA.
Keywords: Smoking, Nicotine, Tobacco, Smoking cessation, Rheumatoid arthritis


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