COMMENTARY

Getting Your RA Patients to Stop Smoking

Kevin Deane, MD, PhD

Disclosures

February 13, 2017

Efficacy of a Rheumatoid Arthritis-Specific Smoking Cessation Program: A Randomized Controlled Pilot Trial

Aimer P, Treharne GJ, Stebbings S, et al
Arthritis Care Res (Hoboken). 2017;69:28-37

Summary

In this New Zealand–based study, Aimer and colleagues performed a randomized controlled trial comparing two methods for smoking cessation. Method 1 consisted of brief advice, including a novel informational handout about five specific adverse effects of smoking on patients with rheumatoid arthritis (RA) and 8 weeks of subsidized nicotine replacement. Method 2 consisted of brief initial advice, handout, and nicotine replacement (similar to Method 1) but also included additional face-to-face, telephone, and email contact. Thirty-nine current smokers with RA were enrolled and randomly assigned in a 1-to-1 fashion to each arm of the study. The primary outcome was smoking cessation at 6 months.

Overall, 24% of subjects stopped smoking at 6 months, although there was no significant difference between groups (21% for Method 1 vs 24% for Method 2; P = .70). In addition, there was a mean decrease in the number of cigarettes smoked daily of approximately 44%, but this did not differ between groups.

The authors concluded that Method 1 was a reasonable approach to promote smoking individuals with RA.

Viewpoint

This small but elegant study suggests that a brief intervention that includes an RA-specific smoking-related educational activity and nicotine replacement can be effective in getting some individuals with RA to stop smoking. Although smoking cessation is broadly beneficial, it is critically important in RA owing to the numerous known adverse effects of smoking in this disorder, including increased risk for cardiovascular and lung disease, osteoporosis, and worsened disease activity.[1,2]While additional studies are likely needed to determine the optimal ways to improve smoking cessation rates across a broad range of patients, the approach that Aimer and colleagues have taken—in particular, educating patients about the direct adverse effects of smoking in RA—should be something that healthcare providers can implement in practice. Ultimately, applying similar techniques may lead to improved rates of smoking cessation across a variety of rheumatic diseases.

Abstract

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