Abstract
Objective
To examine the relationship between smoking, smoking cessation, and disease characteristics and quality of life (QoL) in spondyloarthritis.
Methods
The Scotland Registry for Ankylosing Spondylitis collects data from clinically diagnosed patients with spondyloarthritis. Clinical data, including Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) scores, were obtained from medical records. Mailed questionnaires contained information on smoking status and QoL (Ankylosing Spondylitis QoL questionnaire [ASQoL]). Linear and logistic regression were used to quantify the effect of smoking, and smoking cessation, on various disease-specific and QoL outcomes, with adjustments for age, sex, deprivation, education level, and alcohol use. Results are presented as regression coefficients (β) or odds ratios (ORs) with 95% confidence intervals (95% CIs).
Results
Data were obtained from 946 participants (73.5% male, mean age 52 years). Current smoking was reported by 22%, and 38% were ex-smokers. Ever smokers had poorer BASDAI (β = 0.5 [95% CI 0.2, 0.9]) and BASFI scores (β = 0.8 [95% CI 0.4, 1.2]), and reported worse QoL (ASQoL β = 1.5 [95% CI 0.7, 2.3]). Compared to current smokers, ex-smokers reported less disease activity (BASDAI β = −0.5 [95% CI −1.0, −0.04]) and significantly better QoL (ASQoL β = −1.2 [95% CI −2.3, −0.2]). They also were more likely to have a history of uveitis (OR 2.4 [95% CI 1.5, 3.8]).
Conclusion
Smokers with spondyloarthritis experience worse disease than those who are never smokers. However, this study provides new evidence that, among smokers, smoking cessation is associated with lower disease activity and better physical function and QoL. Clinicians should specifically promote smoking cessation as an adjunct to usual therapy in patients with spondyloarthritis.
To examine the relationship between smoking, smoking cessation, and disease characteristics and quality of life (QoL) in spondyloarthritis.
Methods
The Scotland Registry for Ankylosing Spondylitis collects data from clinically diagnosed patients with spondyloarthritis. Clinical data, including Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI) scores, were obtained from medical records. Mailed questionnaires contained information on smoking status and QoL (Ankylosing Spondylitis QoL questionnaire [ASQoL]). Linear and logistic regression were used to quantify the effect of smoking, and smoking cessation, on various disease-specific and QoL outcomes, with adjustments for age, sex, deprivation, education level, and alcohol use. Results are presented as regression coefficients (β) or odds ratios (ORs) with 95% confidence intervals (95% CIs).
Results
Data were obtained from 946 participants (73.5% male, mean age 52 years). Current smoking was reported by 22%, and 38% were ex-smokers. Ever smokers had poorer BASDAI (β = 0.5 [95% CI 0.2, 0.9]) and BASFI scores (β = 0.8 [95% CI 0.4, 1.2]), and reported worse QoL (ASQoL β = 1.5 [95% CI 0.7, 2.3]). Compared to current smokers, ex-smokers reported less disease activity (BASDAI β = −0.5 [95% CI −1.0, −0.04]) and significantly better QoL (ASQoL β = −1.2 [95% CI −2.3, −0.2]). They also were more likely to have a history of uveitis (OR 2.4 [95% CI 1.5, 3.8]).
Conclusion
Smokers with spondyloarthritis experience worse disease than those who are never smokers. However, this study provides new evidence that, among smokers, smoking cessation is associated with lower disease activity and better physical function and QoL. Clinicians should specifically promote smoking cessation as an adjunct to usual therapy in patients with spondyloarthritis.
| Original language | English |
|---|---|
| Pages (from-to) | 1407-1413 |
| Number of pages | 87 |
| Journal | Arthritis Care & Research |
| Volume | 69 |
| Issue number | 9 |
| Early online date | 13 Aug 2017 |
| DOIs | |
| Publication status | Published - Sept 2017 |
Bibliographical note
ACKNOWLEDGEMENTSWe would like to thank all the clinicians and research nurses who facilitated recruitment and data collection. In particular we would like to thank the SIRAS steering committee, especially Professor Roger Sturrock (chair) and Dr David Marshall (vice-chair). We would also like to thank the SIRAS coordinating centre study team, in particular Elizabeth Jones, Giles O’Donovan, Nabi Moaven-Hashemi and Flora Joyce. GTJ, GJM and FA conceived of the study. The initially analysis was undertaken by TR, under the supervision of GTJ and LED. GTJ produced the first draft of the manuscript and all authors have provided intellectual input into its revision.
Funding
SIRAS was funded by unrestricted grant from Pfizer and AbbVie.
Keywords
- Spondyloarthritis
- smoking cessation
- disease severity
Access to Document
- Accepted Manuscript
This is the peer reviewed version of the following article:Jones, G. T., Ratz, T., Dean, L. E., Macfarlane, G. J. and Atzeni, F. (2017), Disease Severity in Never Smokers, Ex-Smokers, and Current Smokers With Axial Spondyloarthritis: Results From the Scotland Registry for Ankylosing Spondylitis. Arthritis Care & Research, 69: 1407–1413., which has been published in final form at DOI: 10.1002/acr.23157. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.