Oral contraceptives, cigarette smoking and other factors in relation to arthritis

doi:10.1016/0010-7824(87)90082-5

Contraception

Volume 35, Issue 5, May 1987, Pages 457-464

https://doi.org/10.1016/0010-7824(87)90082-5 Get rights and content

Abstract

The data on oral contraceptive use and arthritis in the Oxford Family Planning Association contraceptive study have been analysed. For rheumatoid arthritis, the rate of first referral to hospital was 0.33 per 1000 woman-years in those who never used oral contraceptives (27 cases), 0.33 per 1000 woman-years in ex-users of oral contraceptives (29 cases) and 0.44 per 1000 woman-years in current users of oral contraceptives (22 cases). Likewise, there was no important association between oral contraceptive use and other forms of arthritis. An unexpected finding was a strong association between referral to hospital for rheumatoid arthritis and cigarette smoking; the rate in women never smoking was 0.27 per 1000 woman-years (34 cases) and in those smoking 15 or more cigarettes per day was 0.64 per 1000 woman-years (19 cases).

References (7)

J.P. Vandenbroucke et al.
Oral contraceptives and rheumatoid arthritis: further evidence for a preventive effect
Lancet
(1982)
Royal College of General Practitioners
Reduction in incidence of rheumatoid arthritis associated with oral contraceptives
Lancet
(1978)
D.J. del Junco et al.
Do oral contraceptives prevent rheumatoid arthritis?
JAMA
(1985)

There are more references available in the full text version of this article.

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Citation Excerpt :
The association between smoking and RA has also been investigated in the context of smoking status and the nuances of serostatus and sex. Many previous studies have investigated smoking status (current vs past vs never as the reference group) and risk of RA.21–30 A meta-analysis of 16 studies showed that having ever smoked increased the odds of developing RA risk by 1.89-fold.31
Lifestyle may be important in the development of rheumatoid arthritis (RA). Therefore, changing behaviors may delay or even prevent RA onset. This article reviews the evidence basis for the associations of lifestyle factors with RA risk and considers future directions for possible interventions to reduce RA risk.
The literature was reviewed for cross-sectional studies, case-control studies, cohort studies, and clinical trials investigating potentially modifiable lifestyle factors and RA risk or surrogate outcomes on the path toward development such as RA-related autoimmunity or inflammatory arthritis. The evidence related to cigarette smoking, excess weight, dietary intake, physical activity, and dental health for RA risk were summarized.
Cigarette smoking has the strongest evidence base as a modifiable lifestyle behavior for increased seropositive RA risk. Smoking may increase seropositive RA risk through gene–environment interactions, increasing inflammation and citrullination locally in pulmonary/oral mucosa or systemically, thereby inducing RA-related autoimmunity. Prolonged smoking cessation may reduce seropositive RA risk. Evidence suggests that excess weight can increase RA risk, although this effect may differ according to sex, serologic status, and age at RA onset. TDietary intake may also affect RA risk: overall healthier patterns, high fish/omega-3 polyunsaturated fatty acid consumption, and moderate alcohol intake may reduce RA risk, whereas caffeine and sugar-sweetened soda consumption might increase RA risk. The impact of physical activity is less clear, but high levels may reduce RA risk. Periodontal disease might induce citrullination and RA-related autoimmunity, but the effect of dental hygiene behaviors on RA risk is unclear. Although the effect size estimates for these lifestyle factors on RA risk are generally modest, there may be relatively large public health benefits for targeted interventions given the high prevalence of these unhealthy behaviors. With the exception of smoking cessation, the impact of behavior change of these lifestyle factors on subsequent RA risk has not been established. Nearly all of the evidence for lifestyle factors and RA risk were derived from observational studies.
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Oral contraceptives, cigarette smoking and other factors in relation to arthritis

Abstract

Lancet

Reduction in incidence of rheumatoid arthritis associated with oral contraceptives

Lancet

Do oral contraceptives prevent rheumatoid arthritis?

JAMA