The effect of snuff (smokeless tobacco) on disease activity and function in rheumatoid arthritis : experiences from the Better Anti-Rheumatic FarmacOTherapy, a longitudinal multicenter study on early rheumatoid arthritis.

• BACKGROUND: It is not known whether snuff (moist smokeless tobacco) affects disease activity in rheumatoid arthritis (RA).OBJECTIVE: This study aims to study the effect of snuff on disease activity and function in Swedish patients with early RA.METHODS: Between 1992 and 2005, 2800 adult patients were included in the Better Anti-Rheumatic FarmacOTherapy (BARFOT) early RA study in Sweden. Disease Activity Score 28 joints (DAS28), Health Assessment Questionnaire, visual analog scale for general health, and drug treatment were registered at inclusion and at follow-up after 1, 2, and 5 years. European League Against Rheumatism response and remission criteria were applied at 1 year. In 2010, a self-completed postal questionnaire was sent to 2102 patients in the BARFOT study enquiring about lifestyle factors such as smoking and use of snuff. Three controls for each patient using snuff were identified.RESULTS: Fifty-one patients who used snuff were identified, together with 145 controls. When we adjusted for socioeconomic class, disease duration, and previous antirheumatic medication, the snuff users had lower DAS28 values at up to 6 months of follow-up than patients who had never smoked, and they had lower DAS28 values than previous smokers at up to 2 years of follow-up. No effect of snuff use on European League Against Rheumatism response was seen at up to 1 year.CONCLUSIONS: Snuff users initially had lower DAS28 levels than never smokers and previous smokers. Copyright © 2013 by Lippincott Williams & Wilkins.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Reumatologi och inflammation (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Rheumatology and Autoimmunity (hsv//eng)

Keyword

epidemiology

Rheumatoid arthritis

smokeless tobacco

snuff

smokeless tobacco

rheumatoid arthritis

snuff

epidemiology

Publication and Content Type

ref (subject category)

art (subject category)