Skip to main content

Advertisement

SpringerLink
Log in

Current cigarette use in rheumatoid arthritis patients: associated factors and a limited mediating role of depression

  • Original Article - Observational Research
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Some newly published studies revealed that current smoking was associated with accelerated disease progression in diagnosed rheumatoid arthritis (RA) patients. The major aims of this study were to analyze the associated factors of current smoking in RA patients and explore the mediating role of depression in the associations between identified factors and smoking. RA patients were selected from NHANES databases 2005–2012. Current smoking was determined by race-specific serum cotinine levels. Depression was measured by the Depression Screener questionnaire. Totally, 848 RA patients were identified and included into final analysis. Logistic regression model founds that age, race, and socioeconomic status (SES) were associated with current smoking in RA patients: the odds ratios (ORs) of smoking were 0.29 (95 % CI 0.17, 0.49) and 0.39 (95 % CI 0.24, 0.62) in patients over 60 years old and of higher SES, respectively; non-Hispanic white patients with a pre-RA smoking history had an OR of 3.48 (95 % CI 1.35, 5.18) when compared with patients of other race with no pre-RA smoking history. Structural equation model identified a weak mediating role of depression, only accounted for 5 % of the total SES–smoking association. In this sample of diagnosed RA patients, age, SES, ethnicity, but not depression, were significantly associated with current smoking.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Helmick CG, Felson DT, Lawrence RC, Gabriel S, Hirsch R, Kwoh CK et al (2008) Estimates of the prevalence of arthritis and other rheumatic conditions in the United States. Part 1. Arthritis Rheum 58:15–25

    Article  PubMed  Google Scholar 

  2. Wolfe F, Michaud K, Gefeller O, Choi HK (2003) Predicting mortality in patients with rheumatoid arthritis. Arthritis Rheum 48:1530–1542

    Article  PubMed  Google Scholar 

  3. Yelin E, Trupin L, Wong B, Rush S (2002) The impact of functional status and change in functional status on mortality over 18 years among persons with rheumatoid arthritis. J Rheumatol 29:1851–1857

    PubMed  Google Scholar 

  4. Smolen JS, Aletaha D, Bijlsma JW, Breedveld FC, Boumpas D, Burmester G et al (2010) Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis 69:631–637

    Article  PubMed Central  PubMed  Google Scholar 

  5. Criswell LA, Saag KG, Mikuls TR, Cerhan JR, Merlino LA, Lum RF et al (2006) Smoking interacts with genetic risk factors in the development of rheumatoid arthritis among older Caucasian women. Ann Rheum Dis 65:1163–1167

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  6. Hutchinson D, Shepstone L, Moots R, Lear JT, Lynch MP (2001) Heavy cigarette smoking is strongly associated with rheumatoid arthritis (RA), particularly in patients without a family history of RA. Ann Rheum Dis 60:223–227

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  7. Carlens C, Hergens MP, Grunewald J, Ekbom A, Eklund A, Höglund CO et al (2010) Smoking, use of moist snuff, and risk of chronic inflammatory diseases. Am J Respir Crit Care Med 181:1217–1222

    Article  PubMed  Google Scholar 

  8. Mikuls TR, Sayles H, Yu F, Levan T, Gould KA, Thiele GM et al (2010) Associations of cigarette smoking with rheumatoid arthritis in African Americans. Arthritis Rheum 62:3560–3568

    Article  PubMed Central  PubMed  Google Scholar 

  9. Hyrich KL, Watson KD, Silman AJ, Symmons DP (2006) Predictors of response to anti-TNF-alpha therapy among patients with rheumatoid arthritis: results from the British Society for rheumatology biologics register. Rheumatology 45:1558–1565

    Article  CAS  PubMed  Google Scholar 

  10. Manfredsdottir VF, Vikingsdottir T, Jonsson T, Geirsson AJ, Kjartansson O, Heimisdottir M et al (2006) The effects of tobacco smoking and rheumatoid factor seropositivity on disease activity and joint damage in early rheumatoid arthritis. Rheumatology 45:734–740

    Article  CAS  PubMed  Google Scholar 

  11. Mattey DL, Brownfield A, Dawes PT (2009) Relationship between pack-year history of smoking and response to tumor necrosis factor antagonists in patients with rheumatoid arthritis. J Rheumatol 36:1180–1187

    Article  PubMed  Google Scholar 

  12. Lu B, Rho YH, Cui J, Iannaccone CK, Frits ML, Karlson EW et al (2014) Associations of smoking and alcohol consumption with disease activity and functional status in rheumatoid arthritis. J Rheumatol 41:24–30

    Article  PubMed Central  PubMed  Google Scholar 

  13. Chaiton MO, Cohen JE, O’Loughlin J, Rehm J (2009) A systematic review of longitudinal studies on the association between depression and smoking in adolescents. BMC Public Health 9:356–366

    Article  PubMed Central  PubMed  Google Scholar 

  14. Tjora T, Hetland J, Aarø LE, Wold B, Wiium N, Øverland S (2014) The association between smoking and depression from adolescence to adulthood. Addiction 109:1022–1030

    Article  PubMed  Google Scholar 

  15. Park S (2009) The causal association between smoking and depression among South Korean adolescents. J Addict Nurs 20:93–103

    Article  Google Scholar 

  16. Matcham F, Rayner L, Steer S, Hotopf M (2013) The prevalence of depression in rheumatoid arthritis: a systematic review and meta-analysis. Rheumatology 52:2136–2148

    Article  PubMed Central  PubMed  Google Scholar 

  17. Florescu A, Ferrence R, Einarson T, Selby P, Soldin O, Koren G (2009) Methods for quantification of exposure to cigarette smoking and environmental tobacco smoke: focus on developmental toxicology. Ther Drug Monit 31:14–30

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  18. Benowitz NL, Bernert JT, Caraballo RS, Holiday DB, Wang J (2009) Optimal serum cotinine levels for distinguishing cigarette smokers and nonsmokers within different racial/ethnic groups in the United States between 1999 and 2004. Am J Epidemiol 169:236–248

    Article  PubMed  Google Scholar 

  19. WHO (1995) Physical status: the use and interpretation of anthropometry. World Health Organization, Geneva

    Google Scholar 

  20. Kupek E (2006) Beyond logistic regression: structural equations modelling for binary variables and its application to investigating unobserved confounders. BMC Med Res Methodol 6:13

    Article  PubMed Central  PubMed  Google Scholar 

  21. Hooper D, Coughlan J, Mullen M (2008) Structural equation modelling: guidelines for determining model fit. Electron J Bus Res Methods 6:53–60

    Google Scholar 

  22. Centers for Disease Control and Prevention (2014) Current cigarette smoking among adults—United States, 2005–2012. Morb Mortal Wkly Rep 63:29–34

    Google Scholar 

  23. Brunet L, Pai M, Davids V, Ling D, Paradis G, Lenders L et al (2011) High prevalence of smoking among patients with suspected tuberculosis in South Africa. Eur Respir J 38:139–146

    Article  CAS  PubMed  Google Scholar 

  24. Schnoll RA, Engstrom PF, Subramanian S, Demidov L, Wielt DB, Tighiouart M (2006) Prevalence and correlates of tobacco use among Russian cancer patients: implications for the development of smoking cessation interventions at a cancer center in Russia. Int J Behav Med 13:16–25

    Article  PubMed  Google Scholar 

  25. Poirier MF, Canceil O, Baylé F, Millet B, Bourdel MC, Moatti C et al (2002) Prevalence of smoking in psychiatric patients. Prog Neuropsychopharmacol Biol Psychiatry 26:529–537

    Article  PubMed  Google Scholar 

  26. Källberg H, Ding B, Padyukov L, Bengtsson C, Rönnelid J, Klareskog L et al (2011) Smoking is a major preventable risk factor for rheumatoid arthritis: estimations of risks after various exposures to cigarette smoke. Ann Rheum Dis 70:508–511

    Article  PubMed Central  PubMed  Google Scholar 

  27. Ostroff JS, Jacobsen PB, Moadel AB, Spiro RH, Shah JP, Strong EW et al (1995) Prevalence and predictors of continued tobacco use after treatment of patients with head and neck cancer. Cancer 75:569–576

    Article  CAS  PubMed  Google Scholar 

  28. Bjordal K, Kaasa S (1995) Psychological distress in head and neck cancer patients 7–11 years after curative treatment. Br J Cancer 71:592–597

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  29. Piper ME, Cook JW, Schlam TR, Jorenby DE, Smith SS, Bolt DM et al (2010) Gender, race, and education differences in abstinence rates among participants in two randomized smoking cessation trials. Nicotine Tob Res 12:647–657

    Article  PubMed Central  PubMed  Google Scholar 

  30. Berg CJ, Wen H, Cummings JR, Ahluwalia JS, Druss BG (2013) Depression and substance abuse and dependency in relation to current smoking status and frequency of smoking among nondaily and daily smokers. Am J Addict 22:581–589

    Article  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by National Natural Science Foundation of China [Grant No. H2611].

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of Biostatistics, School of Public Health, Fudan University, 130th Dong’an Road, Shanghai, 200032, China

    Yuanyuan Xiao & Naiqing Zhao

  2. Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, Zhejiang, China

    Yuanyuan Xiao

Authors
  1. Yuanyuan Xiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Naiqing Zhao
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Naiqing Zhao.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xiao, Y., Zhao, N. Current cigarette use in rheumatoid arthritis patients: associated factors and a limited mediating role of depression. Rheumatol Int 35, 1219–1224 (2015). https://doi.org/10.1007/s00296-015-3216-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-015-3216-2

Keywords

Search

Navigation