A systematic review with meta-analysis of the effects of smoking cessation strategies in patients with rheumatoid arthritis

• Published in: PloS one Vol. 17; no. 12; p. e0279065
• Main Authors: Lopez-Olivo, Maria A, Sharma, Gaurav, Singh, Gagandeep, James, Justin, Krause, Kate J, Cinciripini, Paul, Volk, Robert J, Suarez-Almazor, Maria E
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 15.12.2022; Public Library of Science (PLoS)
• Subjects: Arthritis; Arthritis, Rheumatoid - chemically induced; Arthritis, Rheumatoid - therapy; Best practice; Bias; Biology and Life Sciences; Cardiovascular diseases; Care and treatment; Cigarette smoking; Clinical trials; Data collection; Disease; Drug addiction; Education; GDP; Gross Domestic Product; Health aspects; Health risks; Humans; Intervention; Medicine and Health Sciences; Meta-analysis; Mortality; Nicotine; Nicotine - adverse effects; Patient outcomes; Population; Population studies; Populations; Rheumatoid arthritis; Risk analysis; Risk factors; Smoking; Smoking - drug therapy; Smoking - therapy; Smoking cessation; Smoking Cessation - psychology; Smoking cessation programs; Social Sciences; Systematic review; Tobacco; Tobacco Use Cessation Devices; United States
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0279065

Smoking rates among patients with rheumatoid arthritis (RA) exceed those in the general population. This study identified smoking cessation strategies used in patients with RA and synthesized data on their effects. We conducted a systematic review of studies that reported effects of interventions for smoking cessation in patients with RA. We searched 5 electronic databases until March 2022. Screening, quality appraisal, and data collection were done independently by 2 reviewers. We included 18 studies reporting interventions for patients or providers: 14 evaluated strategies for patients (5 education on cardiovascular risk factors including smoking, 3 educational interventions on smoking cessation alone, 3 education with nicotine replacement and counseling, and 1 study each: education with nicotine replacement, counseling sessions alone, and a social marketing campaign). Smoking cessation rates ranged from 4% (95% CI: 2%-6%, 24 to 48 weeks) for cardiovascular risk education to 43% (95% CI: 21%-67%, 104 weeks) for counseling sessions alone. The pooled cessation rate for all interventions was 22% (95% CI: 8%-41%, 4 weeks to 104 weeks; 9 studies). Four interventions trained providers to ascertain smoking status and provide referrals for smoking cessation. The pooled rates of referrals to quit services increased from 5% in pre-implementation populations to 70% in post-implementation populations. Studies varied in patient characteristics, the interventions used, and their implementation structure. Only 3 studies were controlled clinical trials. Additional controlled studies are needed to determine best practices for smoking cessation for patients with RA.