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Smoking is injurious to various organ systems of human body. Inhaled smoke not only causes inflammation in the lungs but also in rest of the body. Evidence suggests that smoking is an independent risk factor for onset of multiple autoimmune rheumatic diseases like Rheumatiod Arthritis, Lupus (SLE).

It also results in increased number of relapses  in RA despite patients being on regular treatment.Smoking modulate the immune system through many ways including induction of inflammatory response, alteration of cytokine balance, DNA damage and cell death. Smoking reduces the efficacy of antirheumatic drugs in patients. The risk appears elevated even in past smokers until 20 years after cessation.

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