title: Smoking is associated with a worse self-reported health status in patients with psoriatic arthritis: data from a Swedish population-based cohort.
abstract: The aim was to study possible associations between smoking habits and self-reported clinical features in a large population-based cohort of patients with psoriatic arthritis (PsA). All subjects with PsA who had sought health care in the period 2003-2007 were identified using a regional health-care register. In 2009, all those identified who were 18 years of age or more (n = 2,003) were sent a questionnaire with questions on smoking, health-related quality of life [EuroQol five-dimension (EQ-5D)questionnaire], function [Health Assessment Questionnaire (HAQ)], pain, fatigue, and global health. We performed age- and sex-adjusted regression analysis to compare health status outcomes in never and ever smokers. Altogether, 1,185 subjects (59%) returned the questionnaire. Mean age was 57 years (SD 13.5), and 58% were women; 38% were never smokers and 62% were ever smokers. Mean age at disease onset was 38.2 years (SD 13.2) and 41.2 years (SD 13.6), respectively (p = 0.001). In age- and sex-adjusted data, ever smokers reported worse EQ-5D (p = 0.009); worse reports of global health (p = 0.01), pain (p = 0.01), and fatigue (p = 0.04); and a higher number of painful body regions (p = 0.04) compared to never smokers. In this population-based PsA cohort, patients who were ever smokers reported worse health status than never smokers. Besides being a possible result of a worse PsA in ever smokers, impaired health status could also be an effect of unstudied comorbidities. Further longitudinal studies are needed to gain a better understanding of cause and effect. However, smoking cessation should be recommended because of general health considerations as well as disease-specific issues.
authors.affiliation: Department of Rheumatology, Clinical Sciences Lund, Lund University, Lund, Sweden, ann.bremander@spenshult.se.
authors.forename: Ann
authors.initials: A
authors.lastname: Bremander
authors.forename: Lennart T H
authors.initials: LT
authors.lastname: Jacobsson
authors.forename: Stefan
authors.initials: S
authors.lastname: Bergman
authors.forename: Emma
authors.initials: E
authors.lastname: Haglund
authors.forename: Sofia
authors.initials: S
authors.lastname: Löfvendahl
authors.forename: Ingemar F
authors.initials: IF
authors.lastname: Petersson
mesh_terms: D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000150:complications / Q000453:epidemiology / Q000523:psychology*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005221:Fatigue / Q000209:etiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011788:Quality of Life; D012907:Smoking / Q000009:adverse effects*; D013548:Sweden / Q000453:epidemiology