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Education on link to disease may motivate some smokers with RA to quit
Some patients with rheumatoid arthritis reported changes in attitudes about smoking following exposure to a campaign designed to provide motivation for smoking cessation related to the symptoms of rheumatoid arthritis, according to researchers in Fife, Scotland.
A group of 1,000 patients with seropositive rheumatoid arthritis (RA) from the U.K. National Health Service Fife Rheumatology database were informed via a letter about possible contact from a researcher. A pre-campaign questionnaire was randomly assigned to 550 patients, and 450 patients were selected to receive a post-campaign questionnaire through an interview with either a medical student, a rheumatology occupational therapist or a nurse. Of 146 former smokers in the pre-campaign group, 40% reported quitting due to a smoking-related health condition, 15% cited fear of cancer, 23% were self-motivated and 12% were motivated by cost.
Smoking and RA campaign materials were developed with the help of a marketing company. Nine patients with RA who were smokers and members of the National Rheumatoid Arthritis Society provided feedback to determine the most popular image. The following five messages were selected for inclusion in the materials:
smoking can increase your risk of developing RA;
heavy smoking increases the risk of RA by 100%;
smoking can lessen the effect of your treatment;
RA may be more severe in smokers than nonsmokers; and
quitting is one of the best things you could do for your RA.
A press release about the campaign was sent to national and local newspapers and radio stations the same day campaign posters were sent to patients with RA and outpatient departments, general practices, community pharmacies and dental practices in September 2011. Patients who had not been previously contacted were invited to complete the post-campaign questionnaire through an interview in addition to the 62 participants who were identified as smokers from the pre-campaign interview.
Following the campaign, 42 patients with RA who were interviewed were not aware of the links between RA complications and smoking, while 24 patients (32%) said learning about the effects helped them think about quitting and nine patients said the knowledge did not elicit an interest in quitting. In the 62 smokers identified pre-campaign, 15 reported the knowledge influenced an interest in quitting.
Seven of 49 smokers (14%) who reported a reduction in smoking since 2011 cited the knowledge of the link between smoking and RA influenced their decision to cut back in the post-campaign group, while six of 26 smokers (23%) identified pre-campaign said the campaign influenced their decision to cut back.
When asked, “How do you feel about your smoking?” 7% of the pre-campaign group planned to stop, 47% cited concerns about smoking and 46% reported being content with their smoking status. In the post-campaign group, 55% cited being concerned about smoking, 32% reported contentedness and 13% planned to stop. In the group of smokers from the pre-campaign group, 65% cited being concerned about smoking, 33% reported to be content, and 2% planned to quit. – by Shirley Pulawski
Disclosure: Harris reports honoraria from Pfizer, and the research was supported by a grant from Pfizer.