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The latest research on smoking and axial SpA (AS)

Smoking and axial SpA (AS)

Smoking is one of the greatest threats to health in our time. The World Health Organisation estimates that there are 7 million deaths each year as a direct result of tobacco use and a further 1.2 million through secondhand smoke. In the UK, 17% of all deaths in the past 10 years have been attributed to smoking.

So, how big a problem is smoking in axial SpA (AS)? Around a quarter of people living with axial SpA (AS) are current smokers. This is much higher than the UK average of 15%.

A new research paper from Dr Steven Zhao, Dr Nicola Goodson, Dr Selina Robertson and Professor Karl Gaffney takes a look at the available evidence to look at the impact smoking has on axial SpA (AS).

Smoking and disease activity

The researchers took an in-depth look at all published studies on axial SpA (AS) disease activity and smoking status. They found that people who had ever smoked had significantly higher disease activity, functional impairment, pain, and poorer quality of life than those who had never smoked. Smokers also reported worse sleep, fatigue and mental health.

Smoking may cause more severe disease, but equally, severe symptoms may influence smoking behaviour. In a qualitative study of barriers to stopping smoking, it was discovered that many used smoking to distract from or help with pain. This may mean that quitting is harder for precisely the people who need it the most.

All studies found that smokers had a lower likelihood of achieving good response to treatment, partly because they start treatment with high levels of disease activity.

Smoking and psoriasis

Axial SpA (AS) is associated with an increased risk of psoriasis – nearly 1 in 10 people with axial SpA (AS) have psoriasis. In an analysis of the UK’s axial SpA (AS) register, current smokers had 48% higher risk of psoriasis compared to non-smokers, whereas people who quit did not. This risk is important for smokers to be aware of as psoriasis has a significant impact on body image, quality of life and mental health.

Smoking and uveitis

Up to a quarter of people with axial SpA (AS) will develop uveitis. Uveitis is a painful and potentially sight-threatening feature of axial SpA (AS). Smoking increases the risk of recurrent attacks of uveitis by 33% compared to non-smokers. This risk is reduced in people who manage to quit smoking.

Getting help and support to stop smoking

Here are some practical, quick and simple steps you can take to quit smoking.

  • Talk to your GP. Your GP can help by signing you up to a Stop Smoking Clinic, and prescribing nicotine replacement therapy, such as patches and gum, or stop smoking medication
  • Join your local stop smoking service. Research shows you’re up to four times more likely to quit successfully with the help of your local stop smoking service. They are manned by trained advisers and are available all around the UK. You can choose between a local group that meets once a week or one-to-one support. You usually go for a few weeks and work towards a quit date. Find your nearest service or call the Smokefree National Helpline on 0300 123 1044 to speak to a trained adviser.
  • Find online support. The Smokefree website includes a range of free online support
  • Consider using nicotine replacement therapy. Cigarettes are addictive, and self-control alone might not be enough for you to stop. Nicotine replacement therapy is available on prescription from your GP, from your local stop smoking service or from a pharmacist