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RA, Smoking, and Alcohol

The potential risks smoking and drinking pose to people with rheumatoid arthritis.

Health Problems From Smoking and RA continued...

Stroke is another concern for RA patients.

"RA is an illness like diabetes. In and of itself, it's a risk factor for heart attack and stroke," says Andrew Ruthberg, MD, an assistant professor of medicine and an attending physician at Rush University Medical Center and director of Rush Rheumatoid Arthritis Clinic. "And those two things conspire to raise your risk for those other problems to a higher level."

The bottom line: Quit. But Goodman says she doesn't always address that first.

When patients come into her office for treatment, Goodman first focuses on getting their pain under control. After that, she then turns to their bad habits -- like smoking.

"Certainly, everyone should quit smoking," Goodman says. “And we try to help the patient do that.”

Ruthberg takes a harder stance.

"I don't smoke myself," he says, "and I don't much like smoking. My father died of lung cancer, so it doesn't take much for me to discourage anyone who smokes from smoking. But I usually talk about other health risks associated with smoking, like heart attacks and strokes."

Do Alcohol and RA Medications Mix?

The lines between rheumatoid arthritis and drinking are blurrier. Alcohol doesn't promote or help cause RA like smoking does. But mixing alcohol and medications can lead to liver problems.

Some studies have found that drinking in moderation may help lower the chance and the symptoms of rheumatoid arthritis. A study published online in Rheumatology in July 2010 found that drinking alcohol more than 10 days a month decreases "both risk and severity" of the disease. The study was based on information collected from patients about their drinking habits, which doesn’t prove drinking alcohol counters RA or its effects.

"We don't spend very much time encouraging people to drink alcohol," Moore says, "and all things being considered, we are using drugs that have hepatotoxicity [are toxic to the liver] as part of the patients' regimens."

The drug he's talking about is methotrexate, a common RA medication. Mixing alcohol and RA medications like methotrexate, in particular, is risky. Plus, he says he'd like to see more information, like how much alcohol and what kinds -- whether liquor, beer, or wine -- helped people more before he'd suggest to his patients who have mild forms of RA that they might benefit from drinking alcohol.

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