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Not everyone with a genetic profile associated with RA will develop the disease, and while not all environmental factors are known, smoking tobacco has been consistently identified as a major contributor to the risk of developing RA that is associated with elevated levels of anticyclic citrullinated peptide (anti-CCP), which in turn is associated with more aggressive disease and severe joint erosion (5)

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Smoking can also inhibit the immune systems antibody production

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Statistically significant larger values of erythrocytes were noted in male smokers in relation to female smokers

Meanwhile, as of 2024, 100% of the global adult population can legally purchase deadly combustible cigarettes