Stopping smoking cuts the risk of RA

Stopping smoking cuts the risk of RA

People with rheumatoid arthritis who smoke often have more pain than non-smokers. In addition, drugs against RA are less effective for smokers. There are convincing reasons why people with RA should try to quit. Researchers have also found clear links between smoking and the onset of the disease.

Smoking and RA are not good friends. Most people know smoking is not good for the body in general, but it is even worse for people with RA who smoke. Studies have shown that smoking RA patients have more pain, more swollen joints, more impact on the cartilage and bones, and are more at risk of getting the disease in other organs than their joints compared to non-smoking people with RA. Research results also show that the drugs that are often used in RA work poorly for people who smoke. Smoking not only increases the risk of a more severe course of the illness but also reduces the chances that treatment will have a good effect.

The risk of rheumatoid arthritis (RA) is twice as high for smokers compared to non-smokers. The increase in risk is the same as that from having an inheritance facility for RA. Combining smoking with a hereditary risk of RA is extra risky. A major smoker who also carries genetic factors may a risk of developing RA of up to 40% during their lifetime.

It is still unclear why smoking increases the risk of RA and affects the course of the disease. But researchers suspect that smoking can contribute to a change in certain proteins in the lungs of people at increased hereditary risk of RA. This, in turn, can trigger an immune response that increases the risk of RA. It is probably the smoke itself and not the nicotine that causes irritation in the lungs. (1.2)

What happens to the risk of RA if you stop smoking?

Several research studies have investigated how things change for a person who quits smoking, and if their risk of developing RA decreases. A spring 2019 study attempted to answer the questions “Can people who quit smoking postpone or prevent the onset of RA? Is the increase in risk permanent and irrevocable if you ever smoked, or can you change your risk of the disease if you stop smoking? ”

The results of the study showed that the risk starts to decrease about five years after a person has stopped smoking and continues to decrease the longer they refrain from smoking. Participants in the study who quit smoking for good reduced their risk of RA by 37 percent after 30 years, compared with if they had continued smoking. So if you have smoked in the past, the risk is lower the longer you stop. (3)

Another study showed a significant relationship between how much a person smokes (one to seven cigarettes per day) as well as the duration of smoking (1 to 25 years), compared with people who never smoked. You could see that both how many cigarettes a person smokes per day and how many years a person smokes for both have an associated risk of RA. Among former smokers, the risk of developing RA seemed to decrease more as long as they did not smoke. Women who quit smoking 15 years before follow-up had a 30 percent lower risk of RA compared to those who stopped just one year before follow-up. This means that even those who smoke a smaller number of cigarettes a day increase their risk of getting sick. (4)

Passive smoking can increase the risk for children

70,000 women participated in a study, of whom 1,239 of them had RA. Those who were smokers and who had been exposed to passive smoking in their childhood had a 73 percent higher risk of RA compared to those who did not smoke and had not been exposed to smoke in childhood. For smokers who had not been exposed to passive smoking in childhood, the corresponding figure was 37 percent higher risk. This indicates that there is a connection between both passive smoking in childhood and active smoking later in life and an increased risk of RA. (5)

Stopping smoking has a quick effect on health

Do you have RA and want to quit smoking? There is hardly anything that gives as quick and positive an effect on health as stopping smoking (although it takes longer to reduce the risk of suffering from RA). Anyone who has difficulty quitting on their own can take medication to help. As soon as you stop smoking, your body begins its recovery work:

  • 20 minutes after you last inhale, your blood pressure and heart rate have dropped to normal and your blood vessels are widening.

  • After eight hours, the carbon monoxide in the blood decreases and oxygen levels in the blood begin to return to normal.

  • After a day, the risk of heart attack decreases.

  • After three months, blood circulation and lung capacity have improved markedly and fitness has increased by 15 percent. Women's chances of getting pregnant increase significantly, as have men's ability to get an erection. The sense of taste and smell returns.

  • After six months, damage to the blood vessels has begun to be repaired and the risk of blood clots has decreased.

  • After one year, the risk of heart attack has been halved.

  • After five years, the risk of stroke or heart attack is almost as small as in a person who has never smoked. The risk of developing cancer of the larynx, bladder or pancreas has been significantly reduced.

  • After ten years, the risk of lung cancer has dropped by two-thirds.

  • After 15 years, the health risks associated with smoking are almost as low as those who have never smoked. (6)

Do you use the Elsa app?

In Elsa you can keep track of your smoking. In the daily login, you enter the number of cigarettes you have smoked. Try to reduce how much you smoke and see over time how it changes your feelings about your health for the better.


  1. Tobaksbruk och reumatisk sjukdom (2017) , LIR - Levnadsvanearbete inom reumatologi.

  2. Hedström, AK,. Stawiarz, L., Klareskog, L & Alfredsson, L. (2018) Smoking and susceptibility to rheumatoid arthritis in a Swedish population-based case-control study. Eur J Epidemiol (4):415-423. DOI:10.1007/s10654-018-0360-5. Epub 2018 Jan 31.

  3. Liu, X,. Tedeschi, S., Barbhaiya, M., Leatherwood, C., Speyer, C., Lu, B Costenbader, K., Karlson, E & Sparks, J. (2019)  Impact and timing of smoking cessation on reducing risk for rheumatoid arthritis among women in the Nurses’ Health Studies. Arthritis Care & Research. DOI:10.1002/acr.23837

  4. Di Giuseppe, D., Orsini, N., Alfredsson, L., Askling, J & Wolk, A. Cigarette smoking and smoking cessation in relation to risk of rheumatoid arthritis in women. Abstract. Arthritis Res Ther. 2013 Apr 22;15(2):R56. DOI: 10.1186/ar4218.

  5. Seror, R., Gusto, G., Boutron-Ruault, MC & Mariette, X. Passive smoking in childhood and history of chronic diarrhoea increases the risk of developing rheumatoid arthritis (RA). EULAR 2017; Madrid: Abstract OP0253

  6. Hjärt-Lungfonden webbsida. Hjärt-Lungfondens faktablad om Tobak. Vetenskapligt ansvarig: Hans Giljam, professor emeritus vid Institutionen för folkhälsovetenskap, Karolinska Institutet, Stockholm