Smokeless Tobacco (Moist Snuff) Use and the Risk of Developing Rheumatoid Arthritis: Results From a Case–Control Study
Version of Record online: 25 SEP 2014
Copyright © 2014 by the American College of Rheumatology
Arthritis Care & Research
Volume 66, Issue 10, pages 1582–1586, October 2014
How to Cite
Jiang, X., Alfredsson, L., Klareskog, L. and Bengtsson, C. (2014), Smokeless Tobacco (Moist Snuff) Use and the Risk of Developing Rheumatoid Arthritis: Results From a Case–Control Study. Arthritis Care Res, 66: 1582–1586. doi: 10.1002/acr.22325
- Issue online: 25 SEP 2014
- Version of Record online: 25 SEP 2014
- Accepted manuscript online: 9 APR 2014 09:57AM EST
- Manuscript Accepted: 18 MAR 2014
- Manuscript Received: 25 NOV 2013
- Swedish Research Council for Health
- Working Life and Welfare
- Swedish Research Council
- AFA Insurance Company
- King Gustaf V's 80-Year Foundation
- Swedish Rheumatism Foundation
- European Union–funded Innovative Medicines Initiative (BTCure)
To investigate the association between snuff use (smokeless tobacco containing nicotine) and the risk of anti–citrullinated protein/peptide antibody (ACPA)–positive and ACPA-negative rheumatoid arthritis (RA).
Data from the Swedish Epidemiological Investigation of Rheumatoid Arthritis, a population-based case–control study including 1,998 incident cases and 2,252 randomly selected controls (matched on age, sex, and residential area) ages 18–70 years, were analyzed. Ever, current, and past moist snuff users were compared with never users. We calculated odds ratios (ORs) with 95% confidence intervals (95% CIs) by means of unconditional logistic regression models. All analyses were adjusted for cigarette smoking, alcohol consumption, and the matching variables.
In total, 254 (13%) cases were ever moist snuff users compared with 290 (13%) controls, resulting in an OR of 1.0 (95% CI 0.8–1.2) of RA overall. When exposure to moist snuff was analyzed in relation to ACPA-positive and ACPA-negative disease, no associations were observed. Neither current nor past moist snuff use was related to the risk of any of the 2 RA subgroups. Analyses restricted to never smokers provided similar results.
The use of moist snuff was not associated with the risk of either ACPA-positive or ACPA-negative RA. The increased risk of RA associated with smoking is most probably not due to nicotine.