Environmental Epidemiology and Risk Factors for Autoimmune Disease

M. A. Dooley, MD, MPH, S. L. Hogan, PhD, MPH

Curr Opin Rheumatol. 2003;15(2)

Cigarette Smoking

Cigarette smoking was associated with an increased risk of developing RA.^[23,24] Three US-based studies report no association between smoking and the onset of SLE,^[17*,25*,26] while three case control studies from Japan, the United Kingdom, and Sweden detected statistically significant increased risks of developing SLE among current smokers.^[23,27,28*] Cigarette smoking has been identified as a risk factor leading to the development of lupus nephritis with poor outcome.^[29,30,31] The apparent contradictions among studies may reflect differences in exposures. Information on the composition of cigarettes is proprietary and does not require disclosure in many countries, including the United States. There may be considerable differences in nicotine and other cigarette components among geographic regions.^[32] Differences in cigarette products with respect to pesticides or fertilizers applied, curing practices, ingredients, filters, additives, papers, and other components could account for these differences in the associations been between smoking and SLE from country to country.

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