Smoking in spondyloarthritis: Unravelling the complexities

Sizheng Steven Zhao, Nicola J. Goodson, Selina Robertson, Karl Gaffney

Research output: Contribution to journalReview articlepeer-review

21 Citations (Scopus)


Tobacco smoking is a major threat to health. There is no doubt about the need to promote and support cessation at every opportunity. Smoking has a clear role in RA, but what evidence is there that the same relationship exists in SpA? In this review, we examine (the less cited) paradoxes and contradictions in the existing axial SpA (axSpA) and PsA literature; for example, smoking appears to be 'protective' for some axSpA manifestations. We also highlight findings from higher quality evidence: smoking is associated with increased risk of PsA and the risk of psoriasis in axSpA. The relationship between smoking and SpA is far from simple. Our aim is to highlight the harms of smoking in SpA and bring attention to inconsistencies in the literature to inform further research.

Original languageEnglish
Pages (from-to)1472-1481
Number of pages10
Issue number7
Early online date1 Apr 2020
Publication statusPublished - 1 Jul 2020


  • ankylosing spondylitis
  • arthritis
  • axial spondyloarthritis
  • extra-articular manifestations
  • observational studies
  • psoriasis
  • psoriatic arthritis
  • smoking
  • tobacco
  • uveitis

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