Background Autoimmune rheumatic diseases are associated with increased cardiovascular mortality compared to the general population
Objectives To evaluate the impact of an intervention carried out by the rheumatologist and nurse in smoker patients.
Methods We selected consecutive active smokers attended at the rheumatology clinics with rheumatoid arthritis, spondyloarthritis or connective diseases. The intervention consisted of two phases: 1) A baseline visit which included the rheumatologist advice on the benefits of quitting smoking, oral and written in a specific information form for rheumatic patients. Patients completed a questionnaire that included smoking-dependence tests and previous quit attempts. 2) A telephone follow-up visit at the 3rd month done by the rheumatology nurse, which included oral reinforcement, the offer of an additional visit and the possibility of pharmacological treatment to help quitting. The primary outcome variable was the percentage of smokers with total abstinence in the last 7-days of a phone interview at 3, 6 and 12 months. The secondary endpoint was a reduction in cigarette consumption by at least 50%.
Results 945 patients participated in the study, 233 (24.7%) were former smokers and 185 (19.5%) were current smokers. In the last five years, 55 patients quit smoking, sothe annual withdrawal rate was 4.6%. The smoking cessation rate in 152 participants was 11.8% at 3 months, 14.4% at 6 months and 15.7% at 12 months (Table). The OR at 12 months compared with the previous smoking cessation rate was 3.8 (CI 95%: 1.8-8.1). 29 patients (19%) reduced ≥ 50% of the cigarette consumption at 12 months. In a linear regression analysis in which the dependent variable was smoking cessation at 12 months, a score of less dependence (p=0.03) and previous quit attempts (p=0.04) were significantly associated with definitive smoking cessation.
Conclusions An educational program for smoker patients, which includes oral and written advice by the rheumatologist and the nurse, makes that one out of six patients cease to smoke at 12 months. As far as we know, this is the first interventional study in smokers with arthritis. It has the advantage of a simple design that can be easily integrated into routine daily practice.
Disclosure of Interest None Declared