Smoking, Drinking, and Rheumatoid Arthritis – WebMD

Smokers have higher levels of inflammatory proteins called cytokines in their body. These play a role in the joint and organ damage that comes with RA. Tobacco smoke causes your body to release all kinds of cytokines linked to inflammation in RA.

Smoking may also cause your body to make anti-CCP antibodies. These can lead to more severe RA in people with a gene called HLA-DRB1.

Smoking Can Make RA Worse

Smokers with RA have a more active disease process than those who never smoked or have stopped smoking. High disease activity in RA often equals swollen or tender joints, signs of high inflammation in your blood, or more joint pain.

Active disease in RA leads to joints that don’t work as well. They can become stiff, bent, or damaged. You may even need surgery to repair or replace them down the road.

Your Meds May Not Work as Well

Smokers with RA don’t respond as well to many RA treatments.

They’re less likely to be able to get into remission, which means their disease activity is very low. They usually have worse RA-related symptoms because their drugs just don’t work as well.

It Can Lead to Complications

Inflammation can cause heart disease, so you’re already more likely to get it if you have RA. If you smoke, too, your odds go even higher.

If you have RA, don’t smoke. If you do smoke, talk to your doctor about quitting. They can suggest treatments and put you in touch with counseling or support groups that may help you kick the habit.

Can You Drink if You Have RA?

If you enjoy beer, wine, or a mixed drink now and then, it may be good for you even if you have RA. The catch: You need to limit how much you drink.

You could lower your risk of heart disease or even death if you’re a light to moderate drinker, even more than if you don’t drink at all. That’s true even if you take methotrexate, a common RA treatment.

What’s moderate drinking? It’s only about one small drink per day for women and two drinks per day for men. That’s about 14 grams of alcohol per drink, since every type of drink has other ingredients too, such as water or sugar.

Drink sizes really vary, but standard servings of alcohol are:

  • 12 ounces of beer
  • 8 ounces of malt liquor
  • 5 ounces of wine
  • 1.5 ounces of liquor or whiskey

It Can Affect Some Meds

Talk to your doctor before you open your liquor cabinet. If you take some RA medications, such as leflunomide (Arava), you shouldn’t drink at all. Drinking while you take some OTC pain drugs, such as acetaminophen,ibuprofen, or naproxen sodium, raises your risk of stomach or liver damage.

Alcohol and Inflammation

Light to moderate amounts of alcohol may lower the level of some of those cytokines that cause inflammation. But heavy alcohol use can raise it. Too much drinking can also make you more likely to get some types of cancer or diabetes.

But drinking isn’t an RA treatment. If you have RA, the best way to stay healthy and protect your joints is to stick to your treatment plan, exercise, stay at a healthy weight, and avoid smoking.

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