Abstract
BackgroundSmoking is reported to affect the risk of a number of chronic disorders, including rheumatic diseases. Previous cross-sectional studies have shown a lower frequency of smoking in patients with primary Sjögren’s syndrome (pSS). The aim of this study was to investigate the impact of smoking and socioeconomic status on the risk of subsequent diagnosis of pSS in a nested case-control study.MethodParticipants in two large population-based health surveys who were later diagnosed with pSS were identified through linkage with the Malmö Sjögren’s Syndrome Register. Matched controls were obtained from the health surveys.ResultsSixty-three patients with pSS with pre-diagnostic data from the health surveys were identified. Current smoking was associated with a significantly lower risk of later being diagnosed with pSS (odds ratio (OR) 0.3; 95% CI 0.1–0.6). Furthermore, former smoking was associated with an increased risk of subsequent pSS diagnosis (OR 4.0; 95% CI 1.8–8.8) compared to never smoking. Similar results were found in a sub-analysis of patients with reported symptom onset after inclusion in the health surveys. Socioeconomic status and levels of formal education had no significant impact on the risk of later being diagnosed with pSS.ConclusionIn this nested case-control study, current smoking was associated with a reduced risk of subsequent diagnosis of pSS. In addition, former smoking was associated with an increased risk. Whether this reflects a biological effect of cigarette smoking or other mechanisms should be further investigated in future studies.
Highlights
Smoking is reported to affect the risk of a number of chronic disorders, including rheumatic diseases
Former smoking was associated with an increased risk of subsequent primary Sjögren’s syndrome (pSS) diagnosis compared to never smoking
Whether this reflects a biological effect of cigarette smoking or other mechanisms should be further investigated in future studies
Summary
Smoking is reported to affect the risk of a number of chronic disorders, including rheumatic diseases. Previous cross-sectional studies have shown a lower frequency of smoking in patients with primary Sjögren’s syndrome (pSS). Primary Sjögren’s syndrome (pSS) is an autoimmune disease primarily affecting the salivary and lacrimal glands, causing oral and ocular dryness. Other organs such as lungs, kidneys, nervous system, and skin may be affected in the disease [1]. When using the American European consensus group criteria (AECG criteria) [6] the prevalence of pSS is estimated to be between 11.3 and 236.1/100,000 in different European populations. Annual incidence estimates vary between 3.1 and 5.3/100000 [7]
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