For RA, Health Care Plays a Large Role in Smoking Cessation
Health system cessation efforts may be key for successful smoking cessation among patients with rheumatoid arthritis (RA), according to results of a new study.1
“Health care factors, including health system and being new to rheumatology care, were more predictive of smoking cessation in patients with RA than patient sociodemographic factors, suggesting an important role for health system cessation efforts for patients with RA,” the researchers wrote.
To guide the implementation of smoking cessation interventions, the researchers evaluated patient- and health care-level predictors of smoking cessation among 3577 patients with RA.
These patients had been identified through the electronic health record data from 2 health systems. To be eligible for inclusion, the patients had to have received at least 2 ICD diagnosis codes for RA between 2005 and 2016.
Among all patients, 507 had smoked at baseline. Of these, 29% quit over a median 4.75 years.
Patients who were black, men, aged 40 to 59 years, and using Medicaid were significantly more likely to be baseline smokers; however, none of these sociodemographic factors predicted cessation. Rather, it was health care factors that predicted cessation.
In fact, patients with RA who were new to rheumatology care were 60% more likely to quit smoking compared with other patients, and patients with RA in the rural community health system were 66% more likely to quit smoking compared with other patients.
Patients who were seropositive were 43% less likely to quit smoking. In turn, these patients may particularly benefit from cessation support, according to the study authors.
“Our findings point to the impact of health teams that systematically support tobacco cessation, processes that were in place at the rural clinic,” senior author Christie M. Bartels, MD, MS, said in a press release.2 “Likewise, they highlight the need to engage seropositive patients who smoke and are at risk for worse [RA] and cardiopulmonary diseases, which we know are leading causes of death in [RA].”
—Colleen Murphy
References:
- Schletzbaum M, Greenlee R, Piper ME, et al. Predictors of smoking cessation in patients with rheumatoid arthritis in two cohorts: healthcare factors most predictive [published online March 3, 2020]. https://doi.org/10.1002/acr.24154.
- Certain factors predict smoking cessation in patients with rheumatoid arthritis. News release. Wiley; March 4, 2020. https://newsroom.wiley.com/press-release/arthritis-care-research/certain-factors-predict-smoking-cessation-patients-rheumatoid-.