• Dara Rahmanpour, Aida Malek Mahdavi, Maryam Mahmoudi, Kamal Esalatmanesh, Aisan Akhgari, Mehrzad Hajialilo, Arezou Ghassembaglou, Rojin Farzaneh, Saeed Azizi, and Alireza Khabbazi.
• Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
• Intern Med J. 2024 Mar 1; 54 (3): 467472467-472.

BackgroundEnvironmental factors play an important role in the pathogenesis of rheumatic diseases. Smoking is thought to be a risk factor for autoimmune rheumatic diseases.AimsThe purpose of the present study was to assess the association between smoking and adult-onset Still disease (AOSD) and the effect of smoking on outcomes of this disease.MethodsIn this case-control study, patients with AOSD who met the Yamaguchi criteria, were older than 16 years at the disease onset and were in follow-up for at least 12 months were consecutively enrolled in the study. The outcome of AOSD was assessed by acquiring remission on treatment, remission off treatment, time to remission and rate of flare. The smoking status of participants was defined by direct or phone interviews. Individuals who had smoked daily for at least 6 months were defined as a smoker. We performed propensity score matching analyses by using four parameters, including age, sex, educational status and marital status.ResultsPropensity score matching resulted in 72 patients with AOSD and 216 matched controls. The number of ever smokers in the AOSD and control groups were 11 (15.3%) and 25 (11.6%) respectively. There was no significant increase in the risk of AOSD in multivariate analysis after adjustment for age, sex, marital status and educational level. There were no significant differences in the outcomes of AOSD between ever and never smokers.ConclusionsSmoking probably is not a risk factor for AOSD and did not affect the response to treatment.© 2023 Royal Australasian College of Physicians.

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