Cigarette smoking habits and attitudes among rheumatoid arthritis patients at a tertiary centre in South Africa

Journal of the Colleges of Medicine of South Africa

 
 
Field Value
 
Title Cigarette smoking habits and attitudes among rheumatoid arthritis patients at a tertiary centre in South Africa
 
Creator le Roux, Simon J. Bagula, Herman van Zyl-Smit, Richard Hodkinson, Bridget
 
Subject Rheumatology; Internal medicine; Tertiary medicine rheumatoid arthritis; smoking; nicotine dependence; comorbidities; South Africa
Description Background: People living with rheumatoid arthritis (RA) who smoke cigarettes are known to have worse outcomes with regard to disease control, extra-articular complications and comorbidities. Data regarding this from sub-Saharan Africa is lacking. This study aims to describe the prevalence of cigarette smoking and explore disease control, comorbidities and attitudes of smoking among RA patients in an outpatient clinic at a tertiary hospital.Methods: A cross-sectional study of consenting adult outpatients with RA was conducted. Demographic, clinical and patient-reported outcome measures, together with a questionnaire about smoking and Fagerström test for nicotine dependence, were collated.Results: Of 632 patients (536 female participants), the mean (standard deviation) age and disease duration were 55.4 (13.0) and 10.1 (9.3) years, and 74.1% had two or more comorbidities. Of 218 (34.5%) smokers, more men smoked (p = 0.0002). Compared to non-smokers, smokers had lower body mass index (p = 0.01), higher incidence of chronic obstructive pulmonary disease (p  0.005) and rheumatoid factor positivity (p = 0.006), and higher anxiety scores (p = 0.048) with more impairment in usual activities (p = 0.05). No significant differences in disease activity, extra-articular disease, or in disability, fatigue, depression, or pain scores were observed. The most common reasons for smoking were emotional support (45.8%), nicotine craving (30.5%) and pain control (25.2%). The Fagerström score revealed mild, moderate and severe nicotine dependence in 67.5%, 24.4%, and 7.5%, respectively.Conclusion: One in three patients with RA actively smoked. Those who smoked had more pain, anxiety, and depression but with low nicotine dependency scores.Contribution: The approach to tobacco cessation should occur in parallel with optimal pain, behavioural support and disease control.
 
Publisher AOSIS
 
Contributor
Date 2026-03-19
 
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — cross sectional study
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/jcmsa.v4i1.350
 
Source Journal of the Colleges of Medicine of South Africa; Vol 4, No 1 (2026); 6 pages 2960-110X 3105-4331
 
Language eng
 
Relation
The following web links (URLs) may trigger a file download or direct you to an alternative webpage to gain access to a publication file format of the published article:

https://jcmsa.org.za/index.php/jcmsa/article/view/350/956 https://jcmsa.org.za/index.php/jcmsa/article/view/350/957 https://jcmsa.org.za/index.php/jcmsa/article/view/350/958 https://jcmsa.org.za/index.php/jcmsa/article/view/350/959
 
Coverage Africa; South Africa; Western Cape; Cape Town 02/2021 - 08/2022 age; Gender; Ethnicity; Smokers; Patient reported outcome measures; Co-morbidities
Rights Copyright (c) 2026 Simon J. le Roux, Herman Bagula, Richard van Zyl-Smit, Bridget Hodkinson https://creativecommons.org/licenses/by/4.0
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