You know, when I first got into this racket five or six years ago, I would have never believed smoking — in particular heavy smoking — actually not only can cause arthritis, it makes arthritis far worse for the people who develop it.

This is something I’ve been meaning to touch on for weeks. This topic is an especially raw subject for me, because my mom is absolutely suffering from severe arthritis; she is diabetic and has COPD and high blood pressure, but honestly, the last year or so, it’s been the arthritis that has robbed her the most of her quality of life (And if anyone has witnessed the ravages of COPD, you know that to say that arthritis is wrecking her quality of life more than COPD is a hell of a claim, but it really is. The COPD is under control for the moment, but not the arthritis.)

She can sometimes barely move or walk because of the pain. When I last visited her, she could barely get in and out of bed and could barely use the restroom. She was in agony; it’s in her spine and most of her body, frankly. The only way she could function was by taking oxycontin and other heavy painkillers and they make her sick to her stomach, it’s terrible. When I last saw her, an epidermal had helped her, but she was still getting sick to the stomach from the oxycontin. It’s either throw up a lot or be in excruciating pain — that’s the choice she faces.

I hate to come off like, “she did it to herself,” because frankly, no one even really knew about the connection between smoking and rheumatoid arthritis (from now on, RA, because rheumatoid is a pain in the ass to spell) until a couple of years ago. Additionally, other studies have shown that smoking increases the risk for osteoarthritis (essentially the loss of cartilage — and smoking can cause a deterioration of cartilage, somewhat different from RA), as well. (I’ve had Mom’s arthritis described as both osteoarthritis and RA to me. The story has changed over the years. Her hands look like RA to me.) Anyway, Mom didn’t know, only a few people knew. And frankly, blaming her doesn’t do her or me or anyone any good.

So, to be clear, I am not point a finger and laying blame. Just simply trying to explain the staggering physical damage that smoking causes — and the damage I’ve seen with my own eyes.

I began reading a couple of years ago about the ties between smoking and arthritis. I dismissed it initially; you see a lot of articles splashed all over the Internet saying that smoking is a “risk factor” and , and since then, I’ve seen a literal cascade of information about how smoking both causes RA and makes it far worse. And all I can think of when I read this stories is my mom.

It’s important to remember that RA is an autoimmune disorder. While it is a genetic disorder (as is lung cancer), studies have show that smokers are three times as likely to develop RA as nonsmokers, in particular heavy smokers. So, like lung cancer, smoking is environment and genetics working together to ravage the body.

Earlier this year, the U.S. Surgeon General put out a report on the 50th anniversary on the landmark 1964 USSG report declaring that smoking causes lung cancer detailing all the other diseases believed to be caused or exacerbated by smoking, which people didn’t know in 1964. A the top of this list is diabetes, macular degeneration, erectile dysfunction … and arthritis.

From the 2014 U.s. Surgeon General report:

Immune and autoimmune disorders: This report finds that smoking is a cause of general adverse effects on the body, including systemic inflammation and impaired immune function (Chapter 10). One result of this altered immunity is increased risk for pulmonary infections among smokers. For example, risks for Mycobacterium tuberculosis and for death from tuberculosis disease are higher for smokers than nonsmokers (Chapter 7). Addi­tionally, smoking is known to compromise the equi­librium of the immune system, increasing the risk for several immune and autoimmune disorders. This report finds that smoking is a cause of rheumatoid arthritis, and that smoking interferes with the effectiveness of certain effectiveness of certain treatments for rheumatoid arthritis (Chapter 10).

This report finds that active smoking is now causally associated with age-related macular degeneration, diabetes, colorectal cancer, liver cancer, adverse health outcomes in cancer patients and survivors, tuberculosis, erectile dysfunction, orofacial clefts in infants, ectopic pregnancy, rheumatoid arthritis, inflammation, and impaired immune function.

Rheumatoid Arthritis

1. The evidence is sufficient to infer a causal relationship between cigarette smoking and rheumatoid arthritis.

In addition, a recent Swedish study focused on smoking and RA among women. this study surveyed 34,000 people and found that women smoking as little as one to seven cigarettes a day more than double their risk of developing rheumatoid arthritis.

(My mom, at her heaviest smoking, probably smoked 30-plus cigarettes a day)

Not only does smoking increase the risk of RA, but it makes the arthritis worse and more difficult to treat, other studies have shown.

I mean, this is stuff I didn’t know as recently as a year ago, but the evidence is pretty overwhelming and pretty damning. Just part of the 20th century tobacco holocaust. Even if you are spared lung cancer, there’s so many other things that smoking does to the body. And not only does smoking kill people, it also destroys the quality of life through COPD and arthritis and other diseases. It’s a plague.