Rheumatoid arthritis

Smoking a joint problem

A targeted awareness campaign on the impact of smoking on RA developed and distributed in Scotland, UK  has shown promising results in encouraging RA patients to quit.

In an article published in the Journal of Rheumatology, the researchers evaluated the impact of the educational materials, which spelled out the impacts of smoking on RA risk, on treatment efficacy and the fact that RA is more severe in smokers compared with non-smokers.

Lead author Dr Helen Harris, consultant rheumatologist and lecturer at St Andrew’s University and the Fife Rheumatic Diseases Unit, said smoking cessation should be part of RA treatment because continued smoking inhibited response to treatment and had multiple other risks.

“Smoking cessation is part of the treatment of arthritis just as smoking cessation advice should be given to all patients that smoke and have had a heart attack,” she told the limbic.

Yet the survey showed that almost a third of rheumatologists and more than two thirds of nurses do not give smoking cessation advice, despite it being widely accepted as important in cardiovascular risk management in RA patients.

Dr Harris said she was not surprised at the number of rheumatologists and nurses who reported that they did not give smoking cessation advice to RA patients.

“Many medical staff have not yet learned that giving smoking cessation advice is part of the treatment of RA,” she said.

“Many rheumatology nurses and doctors need training on delivering a 30 second intervention on smoking cessation known as brief advice.”

While the study showed only a small number of smokers with RA quit as a direct result of the awareness campaign, she said it had been an effective way to highlight the link between RA and smoking.

“Our patients knew that smoking could be linked to a heart attack or lung cancer,” Dr Harris said.

“When patients got these conditions they quit. Raising awareness of the relevance of smoking to RA was therefore the first step in helping RA patients to quit.”

She said the visual materials were easily adaptable for use in Australia. Swedish and Norwegian rheumatologists are already using the materials and medics in France are looking at taking up the campaign.

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