Rheumatoid Arthritis Patients Find it Hard to Quit Smoking

A number of barriers found in smoking cessation.

Rheumatoid arthritis (RA) patients may have a more difficult time quitting smoking than their non-smoking counterparts, according to research published in the journal Arthritis Care & Research.

Researchers from the University of Otago in New Zealand studied 36 South Island RA patients, of whom 24 were current smokers and 12 were ex-smokers, in order to investigate disease-related issues that make smoking cessation more challenging for RA patients in particular. The authors additionally aimed to fill the gap in research that details how to tailor smoking cessation interventions for RA patients.

Participants were randomized into groups and either attended a focus group session or an individual interview. All patients completed a standardized questionnaire at the end of their session. The transcripts from the interviews (both group and individual) were then thematically analyzed to identify common threads.

The barriers to smoking cessation that the researchers were able to identify were:

• Patients were unaware of the relationship between smoking and RA, which contributed to the patient not seeing having RA as a reason to quit smoking
• Smoking was used as a distraction from the pain caused by their RA
• There were no other distractions from RA, as RA made it difficult to exercise
• Smoking was used as a coping mechanism for dealing with the frustrations of living with RA
• The participants also identified feeling unsupported and ostracized from other RA patients

“Disease-related issues may hinder smoking cessation for RA patients,” the authors concluded. “Through an understanding of patients’ perspectives there is an opportunity to plan an effective targeted intervention that may increase the chance of smoking cessation in RA patients where smoking may adversely influence disease progression and comorbidities.”

Smoking is a significant risk factor to developing RA, which is more common in women than men, added PhD student and study researcher Pip Aimer.

“We found that nearly two-thirds of the study participants were unaware of a relationship between smoking and RA,” Aimer explained in a statement. “Only six reported changes in their smoking patterns after diagnosis, and these participants starting smoking more heavily.”

Smoking cessation counseling for RA patients should be tailored to fit their needs, alongside standard medication.

“This might include education about the relationship between smoking and RA and identifying suitable targeted exercise for each patient,” Aimer concluded. “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.”