Quitting smoking

Why it matters in rheumatic disease

Smoking is the single best-established lifestyle risk factor for rheumatoid arthritis: it raises the risk of developing it, is linked to more severe disease, and can blunt how well methotrexate and biologic treatments work. It also adds to the cardiovascular risk that inflammatory diseases such as rheumatoid arthritis, lupus, and vasculitis already carry, and it slows healing, which matters if joint surgery is ever on the table.

What quitting does

• Lowers cardiovascular risk, the leading cause of early death in inflammatory arthritis.
• Gives your medications the best chance to work.
• Eases the long-term disease burden and improves healing after surgery.
• Benefits begin within weeks and keep growing the longer you stay stopped.

What actually helps

Quitting is hard, and willpower alone has a low success rate. What works is pairing support with medication:

• Behavioural support (counselling, a quit coach, or a helpline) roughly doubles success and is free through the services below.
• Nicotine replacement therapy, a patch plus a fast-acting form such as gum or a lozenge, eases cravings; in Ontario the STOP program provides it at no cost.
• Prescription options such as varenicline or bupropion can double the chance of quitting; ask your team whether they suit you.
• Set a quit date, tell the people around you, remove triggers, and expect it to take more than one attempt, each try teaches you what helps.

Talk to your team

Your rheumatology and family-medicine teams can build a quit plan with you, prescribe medication, and refer you to a program. Bring it up at your next visit, there is no judgement, only help.