RA, Smoking, and Alcohol

Your joints hurt for weeks from a bout of rheumatoid arthritis (RA). So you reach for a cigarette to make yourself feel better.

You’re really making it worse.

An occasional glass of wine or two, though, is all right -- as long as your doctor gives you the OK.

Will Smoking Ignite Your RA?

No one knows exactly what causes rheumatoid arthritis. But you're more likely to get it if you have a gene for it, and then come in contact with something in your daily life that sets your immune system off. It could be a food, trauma from a fall, pollution, or -- one of the most common triggers -- smoking.

Lighting up might calm your nerves, but it will also speed up the damage RA does to your joints. That will also affect the strength of your grip and make it harder for you to do daily tasks like dressing, walking, and reaching for objects. And it can make you more likely to get bumps under your skin, which your doctor might call rheumatoid nodules.

Smoking can also stop your RA medicine from working as well as it should. It makes it harder for you to control flare-ups or to stay in remission.

But if you used to smoke and then quit, your body should respond to your treatment like normal.

When You Drink With RA

It may be OK for you to have alcohol on occasion. But you have to set limits. Keep it to a drink or two on any given day.

Talk to your doctor first, though, and make sure your drinking doesn’t interfere with your medicines and treatment plan. If your medication bottle's label says not to drink, then don’t partake.

If you take over-the-counter NSAID meds, like ibuprofen and naproxen, know that they come with a risk of stomach bleeding. Alcohol can increase that risk. If you drink while taking methotrexate or leflunomide, you're more likely to get liver damage.

Talk to your doctor to figure out how to keep your liver in good shape if you're a drinker and have rheumatoid arthritis. The benefits of taking your prescribed medicines -- including those that booze may affect -- far outweigh any small perks that alcohol might offer.

RA medications lower inflammation and slow the disease from getting worse. A beer or two can’t compare.

WebMD Feature Reviewed by David Zelman, MD on December 17, 2015


Susan Goodman, MD, assistant attending rheumatologist and internist, Hospital for Special Surgery; assistant professor of medicine, Weill Cornell Medical College.

Walter Moore, MD, senior associate dean for graduate medical education and veteran affair, Georgia Health Sciences University; chief of rheumatology, Charlie Norwood Department of Veterans Affairs Medical Center.

Andrew Ruthberg, MD, assistant professor of medicine; an attending physician at Rush University Medical Center; director, Rush Rheumatoid Arthritis Clinic.

CDC: "Rheumatoid Arthritis."

Källberg, H. Annals of Rheumatic Diseases, March 2011.

Maxwell, J. Rheumatology, November 2010.

Mayo Clinic: "Rheumatoid arthritis."

Merck Manual for Healthcare Professionals. Rheumatoid Arthritis (RA).

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