ArticleAnnals of the rheumatic diseases2018
Cigarette smoking and the risk of systemic lupus erythematosus, overall and by anti-double stranded DNA antibody subtype, in the Nurses' Health Study cohorts.
Article in Annals of the rheumatic diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 1 of them a synthesis that pooled it.
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Who cites it
57 citing papers in PubMed, 1 synthesis or guideline pooled it, 111 citations in OpenAlex.
- Effects of tobacco smoking on cardiovascular disease in patients with systemic lupus erythematosus: A systematic review and meta-analysis.Frontiers in immunology · 2022Pooled it
- Immunopathogenesis of Systemic Lupus Erythematosus: Interplay of Innate and Adaptive Immunity, Microbiome Dysbiosis, and Emerging Therapeutic Targets.Pathophysiology : the official journal of the International Society for Pathophysiology · 2025Review
- Lupus nephritis.Nature reviews. Disease primers · 2025Review
- Impact of Smoking, Steroid Use and Immunosuppression on Anti-dsDNA Antibodies in Systemic Lupus Erythematosus.International journal of molecular sciences · 2025Article
- Ashes to Rashes: An Exploration of the Intersection Between Smoking and Cutaneous Lupus Erythematosus.Biomolecules · 2025Review
- Environmental Risk Factors for Systemic Lupus Erythematosus Through the Lens of Social Determinants of Health.Arthritis care & research · 2025Review
- Systemic lupus erythematosus: updated insights on the pathogenesis, diagnosis, prevention and therapeutics.Signal transduction and targeted therapy · 2025Review
- Risk factors analysis and nomograph model construction of unplanned readmission for ischemic stroke within 31 days in Wenzhou.Frontiers in neurology · 2025Article
- Ultraprocessed Food Intake and Risk of Systemic Lupus Erythematosus Among Women Observed in the Nurses' Health Study Cohorts.Arthritis care & research · 2025Article
- Obesity and tobacco smoking are independently associated with poor patient-reported outcomes in SLE: a cross-sectional study.Rheumatology international · 2024Article
- Vascular damage in systemic lupus erythematosus.Nature reviews. Nephrology · 2024Review
- Environmental pollutants and phosphoinositide signaling in autoimmunity.Journal of hazardous materials · 2024Review
- Environment and systemic autoimmune rheumatic diseases: an overview and future directions.Frontiers in immunology · 2024Review
- Screening for autoimmune diseases in apparently healthy antinuclear antibody positive individuals.Frontiers in medicine · 2024Article
- Prevalence of a large panel of systemic autoantibodies in the Bavarian adult population.Frontiers in immunology · 2024Article
- Association of Ultraviolet B Radiation and Risk of Systemic Lupus Erythematosus Among Women in the Nurses' Health Studies.Arthritis care & research · 2023Article
- Hashimoto's thyroiditis increases the risk of new-onset systemic lupus erythematosus: a nationwide population-based cohort study.Arthritis research & therapy · 2023Article
- Risk prediction models for incident systemic lupus erythematosus among women in the Nurses' health study cohorts using genetics, family history, and lifestyle and environmental factors.Seminars in arthritis and rheumatism · 2023Article
- Serum antinuclear autoantibodies are associated with measures of oxidative stress and lifestyle factors: analysis of LIPIDOGRAM2015 and LIPIDOGEN2015 studies.Archives of medical science : AMS · 2023Article
- Tobacco smoking and risks of more than 470 diseases in China: a prospective cohort study.The Lancet. Public health · 2022Article
Corrections and comments
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesSystemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease, subtyped according to clinical manifestations and autoantibodies. Evidence concerning cigarette smoking and SLE risk has been conflicting. We investigated smoking and SLE risk, overall and by anti-double stranded DNA (dsDNA) presence, in two prospective cohort studies.
methodsThe Nurses' Health Study (NHS) enrolled 121 701 US female nurses in 1976; Nurses' Health Study II (NHSII) enrolled 116 430 in 1989. Lifestyle, environmental and medical data were collected through biennial questionnaires. Incident SLE was confirmed by medical record review. Cox regression models estimated HRs of SLE, overall and by dsDNA subtype, in association with time-varying smoking status and cumulative smoking pack-years through the 2-year cycle prior to diagnosis, controlling for potential confounders.
resultsAmong 286 SLE cases identified (159 in NHS (1978-2012) and 127 in NHSII (1991-2013)), mean age was 49.2 (10.3) years and 42% were dsDNA+ at SLE diagnosis. At baseline, 45% of women had ever smoked, 51% of whom currently smoked. Compared with never smokers, current smokers had increased dsDNA+ SLE risk (HR 1.86 (1.14-3.04)), whereas past smokers did not (HR 1.31 (0.85-2.00)). Women who smoked >10 pack-years (vs never) had an elevated dsDNA+ SLE risk (HR 1.60(95% CI 1.04 to 2.45)) compared with never smokers. No associations were observed between smoking status or pack-years and overall SLE or dsDNA- SLE.
conclusionStrong and specific associations of current smoking and >10 pack-years of smoking with dsDNA+ SLE were observed. This novel finding suggests smoking is involved in dsDNA+ SLE pathogenesis.
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