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Is smoking the trigger?

I have been having a flare up recently, particularly my wrists and feet, but also what appears to be tendon or muscle pains between my left wrist and elbow. Not sure if it could be related to the elbow joint replacement i had 7 years ago, bot that's another story.

I was reading up about RA/RD -causes, symptoms, treatment etc., and read that there was strong evidence to suggest that smoking was a trigger, even if after stopping. It makes me think that I only have myself to blame. Even though my symptoms started some 12 years after I gave up smoking (which was 30 years ago), it was probably a strong contributing factor. I wish young people today could realise the damage they are doing. It's not just heart disease and cancer they should be wary of, but a lifetime of pain and disability!

11 Replies

Hi Jane06,

This is something we are trying to raise awareness of and we partnered with the Stoptober campaign last year to help inform people of the RA risk in smoking. We've got some information on our website at

Here are some of the striking facts:

-Smoking can increase the risk of developing RA by 50%

-Heavy smoking (more than 20 pack-years) can double the risk of developing RA

-Smoking can lessen the effect of your treatment

-RA is more severe in smokers than non-smokers

We'll continue to spread the message and anything you can do to help is fantastic. I hope you feel better soon and get in touch if there's any more information you need.

Take care,

Ruth Grosart

NRAS Digital Media Manager & HU Admin


Ruth - Thank you for the info and useful link. I'll have a look now. I comfort myself by thinking I may have got RD even if I hadn't smoked! Some people do don't they? And I have a strong family history of autoimmune conditions, but I'll never know. Of course I wish i hadn't but there you go!

Jane :)


What a brave post! People don't often say I wish I hadn't smoked . Luckily I never started but as an ex specialist stop smoking advisor I saw how miserable sime people were and how it affected their family and finances xxx


Not so brave really. I am now a very smug anti smoker of 30 years standing, but the fact remains that I smoked during my late teens and early 20's. I don't beat myself up about it. Thanks for your thoughts anyway. Jane x


I don't think anybody can really say for definite what triggers RD. I was diagnosed at 19 and neither myself or parents have ever smoked. Mine is sero-negative inflammatory arthritis. Farm


Speaking here as an ex cigarette smoker who struggled but got past it by vaping. I discussed it with my Rheumy who tells me that as long as her patients have given up cigarettes she's ok with them using alternatives. What she focuses on is stress levels & even though they maybe not fully understood she's of the opinion that unlike cigarettes the chemicals aren't in the liquids. It maybe controversial but it's her preference for those who find it a struggle.

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My grandm mum and aunties have RA and never smoked so.....I think there are so many risk factors it isn't worth blaming yourself. .you lived a good life and we are surviving


Thanks - I agree. I think we are all very unlucky. You have to take life as it comes though. There are always people worse off than you so you just have to be thankful for that. X

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i think we all look for something to blame when we get RA, my first consultant said we have a trigger that can start it and just as likely a trigger to stop it, (although that he said was rarer) mine i put down to being seriously ill whilst I was pregnant with my 4th child, he said it was possible but probably not likely, but that didn't stop me from blaming myself, it has taken years for me to let that one go (he is now 15 i'm still waiting for the off trigger lol) now I just think we have been unlucky!

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I don't know about it being a trigger, but I do know that it is very strongly advised not to smoke (or to give up smoking) if you have spondyloarthritis as I believe there is quite strong evidence that people who smoke have more problems with the disease.

As far as whether a history of smoking could have caused disease 12 years later, I think thats less likely. From what I have read, your risks of smoking related health problems start decreasing fairly shortly after stopping smoking, and by 10 years of being a non-smoker, then you really don't have any greater risk of smoking related disease than someone who hasn't been a smoker. (I'm an ex-smoker myself - smoked a pack a day for 15 years,then gave up about 25 years ago).


I once read a paper about a rat experiment. The basic jist was......... They had rats that had RA. The babies of these RA rats were separated, some were put in a sterile air environment to grow up, and the others were in normal air environment to grow up. None of the ones in the sterile air environment went on to develop RA, but many ones in the normal air environment went on to develop RA.....when they put the rats that grew up in a sterile air environment without RA, into a regular air environment, many then developed RA.

It said RA is likely caused by genetics and a 'trigger' in the environment. They do not know what the environmental trigger is and it did not say if cigarette smoke was part of the normal air environment.

I don't remember the link to the article, but if you google it, you may be able to find it.

I do personally believe cigarette smoke is a trigger, and you don't even have to have smoked, breathing second hand smoke can also be just as bad. When I was a lot younger, smoking used to be allowed in restaurants, and then there was a law, that you have to have a separate smoking section. This gave birth to the Tim Hortons smoking room ( a major Canadian coffee shop) - A plexi-glass room that you go into smoke and have your coffee, it was akin to a smoky Bingo hall, sealed in for freshness!!! I didn't smoke, but my bestie did, I of course went in with her, so she could enjoy her smoke with her coffee, we gabbed for hours. I breathed in a lot of second hand smoke, I didn't think too much about it at the time. Now smoking is banned in any public restaurant, coffee shop, basically everywhere.......

I dont think smoking is a trigger for everyone, but i think it is for some...but its only my opinion, maybe one day scientists will know exactly what causes it. Some people with no family history develop RA too. I wish we knew more, finding the source could help find a cure.


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