TY - JOUR T1 - Smoke gets in your joints? JF - Annals of the Rheumatic Diseases JO - Ann Rheum Dis SP - 453 LP - 454 DO - 10.1136/ard.56.8.453 VL - 56 IS - 8 AU - CHRIS DEIGHTON Y1 - 1997/08/01 UR - http://ard.bmj.com/content/56/8/453.abstract N2 - Two of the commonest causes of death in patients with rheumatoid arthritis (RA) are ischaemic heart disease and respiratory infection, both of which should be exacerbated by cigarette smoking. I shall not insult the readership of the Annalsby listing the many other reasons why patients with RA should not smoke. The paper by Saag et al, in this issue suggests yet another reason that we may not have thrust persuasively at our patients to date.1 This is that smoking may aggravate their RA.The aetiology of RA and pathogenesis of progression to severe RA seem to share much in common. For example being female predisposes to RA, and is associated with more severe articular disease.2Being seropositive for rheumatoid factor (RF) associates with RA, and the higher the titre the more severe the RA.3 Possessing the shared epitope predisposes to RA, and the presence of these alleles leads to more severe disease, particularly when the personhas inherited two copies.4 What we see in RA is a threshold effect. Certain variables seem to push people over … ER -