Department of Health Services Research, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1444, Houston, TX, 77030, USA.
FORWARD, The National Databank for Rheumatic Diseases, Wichita, KS, USA.
Clin Rheumatol. 2023 Aug;42(8):2053-2068. doi: 10.1007/s10067-023-06593-w. Epub 2023 Apr 24.
Tobacco use is highly discouraged in patients with rheumatoid arthritis (RA) due to related short and long-term health implications. We aimed to evaluate smoking cessation patterns in patients with RA. In addition, we ascertained perceptions on the usefulness of quitting methods, and perceived motivators and barriers to quit.
We surveyed adults with RA enrolled in the FORWARD Databank who self-identified as former or current tobacco users.
Three hundred forty-eight participants completed the survey and responded to the question "do you currently smoke" (former use = 319; current use = 29). Nicotine replacement therapy (NRT) was perceived as extremely/somewhat useful by 31%, followed by individual 27% and group counseling 21%. Experiencing a major health event was the most common motivator to quit. Current users on average smoked 17 cigarettes per day. Six of the 29 current users had used electronic cigarettes in the past 30 days. The most frequent methods used to quit were "cold turkey quitting," NRT, and prescription medicines. Only 8 of the 23 current users had plans to quit or expressed being ready to make changes to quit. Reasons most frequently listed to not quit were using smoking to manage negative emotions, as a pleasurable habit, to manage other addictions, and to provide a sense of control (e.g., to cope with RA).
Current users expressed several negative emotions including coping with the disease and "being a pleasurable habit" when trying to quit. Future cessation programs should address these barriers to support patients with RA. Key Points • First study characterizing the smoking behavior of patients with RA in the USA. Current users were younger, had a shorter disease duration, and worse disease outcomes compared to former smokers. • Former and current users reported similar motivators to quit, with experiencing a major health event being most common. Only about a third of participants who quit or who were still smoking received advice from a health professional. • The most common reasons for not quitting were that smoking help to manage negative emotions and was a pleasurable habit. Future studies should focus on cessation programs that support participants with RA by addressing the unique perceptions about smoking in this population.
由于与吸烟相关的短期和长期健康影响，类风湿关节炎（RA）患者应强烈戒烟。本研究旨在评估 RA 患者的戒烟模式。此外，我们还确定了对戒烟方法的看法，以及戒烟的动机和障碍。
我们调查了参加 FORWARD 数据库的自我报告为既往或当前吸烟者的 RA 成年患者。
348 名参与者完成了调查，并回答了“您现在是否吸烟”的问题（既往使用者 319 名；当前使用者 29 名）。尼古丁替代疗法（NRT）被认为非常/有些有用的比例为 31%，其次是个人咨询（27%）和小组咨询（21%）。经历重大健康事件是戒烟的最常见动机。目前的吸烟者平均每天吸烟 17 支。过去 30 天内，29 名当前吸烟者中有 6 人使用过电子烟。过去最常使用的戒烟方法是“突然完全戒烟”、NRT 和处方药。只有 23 名当前吸烟者中的 8 人有戒烟计划或表示准备做出改变以戒烟。大多数人列出的不戒烟的原因包括用吸烟来控制负面情绪、吸烟是一种愉悦的习惯、控制其他成瘾和提供控制感（例如，应对 RA）。
当前的吸烟者在试图戒烟时表达了一些负面情绪，包括应对疾病和“吸烟是一种愉悦的习惯”。未来的戒烟计划应解决这些障碍，以支持 RA 患者。
关键点
· 首次描述美国 RA 患者的吸烟行为。与既往吸烟者相比，当前吸烟者更年轻、疾病持续时间更短、疾病结局更差。
· 既往和当前吸烟者报告的戒烟动机相似，最常见的是经历重大健康事件。大约只有三分之一的戒烟者或仍在吸烟的人从卫生专业人员那里获得了建议。
· 不戒烟的最常见原因是吸烟有助于控制负面情绪和吸烟是一种愉悦的习惯。未来的研究应侧重于通过解决该人群对吸烟的独特看法来支持 RA 患者的戒烟计划。
