Let's unsmoke together! | Figure 1

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Why you should join Figure 1

Background

Tobacco smoking increases the risk of developing inflammatory joint diseases (IJDs) such as rheumatoid arthritis, where the joints are progressively damaged by the body's own immune system. Smoking may also worsen symptoms of these diseases. This review looked at whether supportive programmes to help smokers with IJDs quit smoking actually lead to quitting and reduced inflammation in the joints and elsewhere. Inflammation from these diseases can lead to heart attack and stroke, for which people with IJD are at higher risk.

Study characteristics

We searched the literature in October 2018. We included two studies with a total of 57 adult smokers ‐ both men and women ‐ with rheumatoid arthritis. One of the studies tested an intervention to help people with rheumatoid arthritis to quit smoking. This study recruited only smokers and compared this specialist, stop smoking programme with a standard, less intensive stop smoking programme. The other study tested an intervention to reduce the risk of heart disease and stroke in people with rheumatoid arthritis. Researchers recruited non‐smokers and smokers and compared this programme to a brief factual information leaflet about risks of heart disease. Both studies followed study participants for six months.

Key results

Neither of the two included studies found that the more intensive, specialist interventions aimed at people with rheumatoid arthritis helped more people with rheumatoid arthritis to quit smoking than the less intensive, generic interventions. Only one of the studies reported on the safety of the stop smoking programme used. Very few side effects related to use of nicotine replacement therapy were reported, and none of these were serious. As a result, we do not know whether helping people with inflammatory arthritis improves their disease.

Quality of the evidence

We rated the overall quality of the included studies as very low because studies were very few and included few participants; only one of the studies tested an intervention that specifically tried to help people to quit smoking and there is a chance that people who received the intensive intervention were more likely to incorrectly report that they had stopped smoking when in fact they had not. As a result, further large studies should be carried out to test stop smoking programmes for people with IJD. Researchers should ensure that they measure whether people's IJD symptoms improve, and should confirm whether people have stopped smoking.

Future trials

Future trials on the safety of macrolide antibiotics or quinolone antibiotics for the secondary prevention in adult patients with coronary heart disease do not seem ethical.

Cochrane Review

Key results

12 studies (2818 participants) measured successful quitting at six to nine months follow‐up, and seven studies (2573 participants) measured quitting at 12‐month follow‐up. Partner support did not increase the chances of stopping smoking at either time point.

The analysis split the studies based on the type of partner giving support (relatives/friends/co‐workers versus spouses/cohabiting partners versus fellow cessation‐programme participants). There was no difference in quit rates between study groups, regardless of the type of partner providing the support. Only one study reported that partner support improved more in the group given the partner‐support intervention than in the group where no partner‐support intervention was provided. Another study reported that partner support improved more in a more intensive partner‐support intervention than a less intensive partner‐support intervention.

Quality of the evidence

Overall, the quality of the evidence was low. This review therefore cannot tell us whether receiving more support from a partner can help a person to give up smoking.