Background Autoimmune inflammatory rheumatic diseases (AIRDs) are chronic in nature and common presentation involves the musculoskeletal system. Off lately, the researches have proved the strong association of tobacco in the development of the disease and increasing severity as well as reducing treatment efficacy. Therefore, awareness about the deleterious effect of tobacco and counselling to quit the same should be an imperative part of the patient education.
Objectives To assess the prevalence of tobacco use among patients with AIRDs and the effect of counselling on quitting tobacco.
Methods AIRDs patients attending the rheumatology clinic, willing to participate in the survey were enrolled in this study. Tobacco use was categorized as active [smoking or oral tobacco use] or passive (when the patient was exposed to tobacco smoke).All the information collected in pre-design form, which included demographic information and current status of tobacco use. They were also counselled about the methods of quitting tobacco and its importance and short-term follow-up details were recorded.
Results 361 patients were enrolled in this study, out of them 162 (44.87%) were tobacco-naive and 199 patients (55.12%) were either active or passive tobacco users, among them active tobacco user 113 (56.78%), and passive user 86 (43.21%).Active tobacco users were further classified into mild 53 (47%), moderate 50 (44%) and severe 10 (9%) users. Other characteristics were as follows; Female: Male ratio1.02:1 [F: M (183:178)], Rheumatoid arthritis 268 (74.2%) [F: M (171:97)], Spondyloarthropathy 93 (25.8%) [M: F (81:12)]. Residential details were: urban 284 (79%) and rural 79 (21%). Educational status: 28 (8%) illiterate, 148 (41%) basic education, 106 (29%) graduate, 79 (22%) postgraduate. Co-morbidities status: 123 (34%) having multiple co-morbidities and 238 (66%) have no co-morbidities.
276 (75%) patients were unaware of the ill effects of tobacco use in AIRDs whereas, remaining 85 (25%) were having little knowledge about it.
The results of persistent counselling and creating awareness with the help of audio-visual aids were 49/113 (43.4%) quit from the active user's category, whereas, 64/113 (56.6%) were unable to quit. Among passive users, 9/86 (10.46%) could able to quit whereas in a large significant number of patients follow-up information could not be obtained.
Conclusions The use of tobacco was significantly higher in males (61.80%) than females (38.19%).But females were mainly passively exposed to tobacco. By an intense and regular counselling by the specialist rheumatology nurses; 43.4% of active and 10.4%, passive users were able to quit tobacco.
Aimer P, Treharne GJ, Stebbings S, Frampton C, Cameron V, Kirby S et al. Efficacy of a Rheumatoid Arthritis –Specific Smoking Cessation Program: A Randomized Controlled Pilot Trial. Arthritis Care Res 2017; 69:28–37.
Naranjo A, Khan NA, Cutolo M, Lee SS, Lazovskis J, Pandya S, et.al. Smoking cessation advice by rheumatologist: results of an international survey on behalf of the QUEST-RA group.Rheumatology (oxford) 2014; 53:1825–29.
Acknowledgements The author also wants to thanks, Mr Himanshu Negi (Data Entry help).
Disclosure of Interest S. Baghel: None declared, R. Rawat: None declared, R. Thakran: None declared, C. Messi: None declared, S. Kapoor Consultant for: Advisory board of Novartis,Pfizer, S. Garg Consultant for: Advisory board of Intas, V. Kashyap: None declared, Q. Zaheer: None declared, A. Malaviya Consultant for: Advisory board of IPCA, Janssen, Pfizer, Roche, BMS,Dr. Reddy's, Zydus