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Determination of smoking status of rheumatoid arthritis patients by means of a self-reported questionnaire and serum cotinine assay: a cross-sectional study
  1. Kamran Naraghi1,
  2. Mark Booth2,
  3. Andrew J Russell3,
  4. Jacob M van Laar1,4
  1. 1Rheumatology Department, The James Cook University Hospital, Middlesbrough, UK
  2. 2Wolfson Research Institute, Queen's Campus, Durham University, Thornaby, UK
  3. 3Department of Anthropology, Durham University, Durham, UK
  4. 4Middlesbrough & Institute of Cellular Medicine, Newcastle University, Middlesbrough, UK
  1. Correspondence to Dr Kamran Naraghi, Clinical Trials Doctor, Rheumatology Department, The James Cook University Hospital, Marton Road, Middlesbrough TS4 3BW, UK; kamran.naraghi{at}

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Rheumatoid arthritis (RA) is characterised by a chronic, destructive and debilitating arthritis.1 Smoking may adversely influence the severity of RA as well as its response to treatment in a dose-dependent manner.1,,4 Furthermore, the link between passive smoking and RA has been suggested by some researchers.5 Self-reporting is commonly used to identify the smoking status of RA patients. In the general population, self-reporting underestimates the true rate of smoking.6 7 To what extent this issue affects RA patients in particular is unreported. Unless we correctly ascertain RA patients in terms of smoking status, it will remain difficult to investigate the true impact of smoking, or smoking cessation, on signs and symptoms associated with the disease.

To address this issue, we recently determined the smoking status of RA patients attending the Rheumatology Department of a large university …

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