IMPACT OF TOBACCO SMOKING ON RUN OF RHEUMATIC DISEASES

Abstract

Introduction: The global prevalence of Rheumatic diseases is steadily increasing, presenting a significant public health concern. Among various environmental risk factors, tobacco use is one of the most strongly associated with the development and progression of autoimmune diseases. Smoking-related illnesses account for over 8 million deaths annually, with more than 7 million due to direct tobacco use and the remainder caused by exposure to second-hand smoke. In patients with Rheumatic diseases Smoking has been linked not only to the onset of diseases such as Rheumatoid arthritis and Systemic Lupus Erythematosus but also to increased disease severity, higher inflammatory markers, and reduced treatment efficacy. For instance, a population-based study found that current smokers with rheumatoid arthritis exhibited higher disease activity and lower health-related quality of life compared to non-smokers, while early smoking cessation was associated with improved outcomes. This contributes to a greater health burden through increased morbidity, diminished quality of life, and higher healthcare costs. Addressing tobacco use is therefore essential in the prevention and management of Rheumatic diseases.

Aim of study: The study aimed to assess the impact of tobacco consumption on the prevalence and run of Rheumatic diseases, providing valuable insights into the role of smoking in the progression of these conditions.

Materials and methods: Research was conducted in 2025 at “Solomed” Clinic in Batumi, Georgia, involving 131 patients with different Rheumatic diseases (82 women and 49 men). An anonymous survey was used to assess tobacco use and its impact on disease progression.

Results: Among the 131 patients, 42% (n=55) were active smokers, 31.3% (n=41) passive smokers, and 26.7% (n=35) non-smokers. The highest prevalence of smoking was observed in the 55-65 age group. Rheumatic disease distribution by smoking status included Ankylosing Spondylitis (n=41), Psoriatic Arthritis (n=31), Rheumatoid Arthritis (n=26), Metabolic Arthropathies (n=14), Osteoporosis (n=8), and other joint diseases (n=11). Active smokers were predominantly male. A majority of patients 58.78% (n=77) identified as physically active. Most patients (87.8%, n=115) were receiving treatment for their rheumatic conditions, with 64.89% (n=85) on biological therapy. Notably, 87.1% (n=114) of respondents observed symptom improvement after quitting or attempting to quit smoking. Disease severity was highest among active smokers and lowest among non-smokers. When all groups were combined, 28.3% of patients had mild disease, 31.7% had moderate disease, and 40.0% had severe disease, indicating a clear trend of increasing severity with greater tobacco exposure. These percentages were obtained from data collected through a custom-designed questionnaire, patient anamnesis, laboratory findings, and treatment response, allowing a comprehensive assessment of disease severity across different levels of smoking exposure.

Conclusion: Our study demonstrates that Rheumatic diseases generally require ongoing or long-term medical management, Tobacco use is more prevalent among older adults. The highest number of passive smokers also in this age group. The findings suggest a positive impact of smoking cessation on the run of Rheumatic diseases, highlighting the importance of strengthening preventive measures for this patient population. Disease severity was greatest among smokers and mildest among non-smokers. By our findings, every second individual is classified as an active smoker, every third individual as a passive smoker. Our results highlight the urgent need to raise awareness among patients about the harmful effects of tobacco use and the benefits of smoking cessation.